S1: Daniel Larios is a first year medical resident in Boston.
S2: I switched through different services. My most recent service was in the ICU.
S1: When she says ICU, she means the cove in ICU. And while you might think about being in that type of environment day in, day out as pretty brutal, Dalia thinks about it a little differently.
S2: It may sound cheesy and it may sound silly, but I love, love, love being a doctor. You know, I consider myself incredibly lucky that I am one of the few providers in her hospital who is bilingual and can speak Spanish as well as English.
S3: You’ve probably heard about how this coronavirus is impacting communities of color. The black and brown people are more likely to die from an infection, Dalia. She’s seeing that impact firsthand. How what proportion of patients in the ICU are Spanish speaking? When I went on service, which was just a week ago, I would say about 80 percent, which is much, much higher than we have seen at any point before. And how many of the doctors were Spanish speaking? I can speak for the 19, which is the team that I was on on that team in particular. I was the only physician who spoke Spanish.
S1: Dallas Hospital has translators and fancy iPods so doctors can understand whatever a patient’s saying, but nothing can replace communicating with your actual doctor. Sometimes DeLay is able to offer simple comfort and familiarity. Sometimes speaking Spanish means she can get a patient healthier, faster.
S2: Some of the patients simply cannot speak to you because they are often hooked up to a ventilator. But as we get closer to, for instance, X debating somebody, we win their sedation. And that’s where language becomes really important again, because normally we’ll ask them if they can follow some basic commands. We might ask them, can you squeeze my hand, for instance, or can you raise your arm? And there was this patient we had who we were hoping to excavator to take the ventilator off. So she was asked by multiple team members, simple commands, and she was just not responding to any of them. So the thought of the team was, oh, it’s possible that, you know, she still needs to be on the ventilator longer. She’s not ready to come off. And as part of the night team, I went in and assessed this patient and I asked her the same simple commands, but in Spanish, and she followed all of them. She was able to squeeze my hand. She was able to nod and shake her head appropriately to questions. And it almost made me teary eyed. You know, I knew there was a patient there. There was a person there the whole time, but we simply were not speaking her language.
S1: When you’re in these situations with patients and you’re trying to make them comfortable, trying to assess them the best way you can. I’m wondering how much you share of your own story.
S4: I actually share very little to none, Dalia’s own story is that she’s a Duncker recipient. That means she’s undocumented.
S5: And I think I’ve learned to sort of separate these two aspects of my life. Often I tell people, you know, when I’m in the hospital, I just completely submerged myself into that role. More often than not, I’m I’m sort of this little detective where I’m asking patients about their stories. So I don’t really think about my own until maybe later when I leave the hospital and things kind of fall into place. And I remind myself, actually, I am at this very precarious spot and I might not be able to keep doing that if if certain political decisions don’t go my way sometime in the next few weeks.
S4: The Supreme Court is set to rule on whether Dr. recipients like Dalia can stay in this country. So today on the show, we’ll tell you Dalia’s story. Part of the reason she has thrown herself into caring for Cauvin patients is that it distracts her from thinking too much about something else. Her legal status. I’m Mary Harris. You’re listening to what next? Stick with us.
S1: This DOCA status, Stolley has got its all due to a program created by the Obama administration. It allows those who are brought to the U.S. as children to stay here, get an education, get a job. It was a kind of relief for people like Dolia, sometimes called dreamers. These are people who are undocumented, not because of choices they themselves made, but choices their parents made for them. There are nearly 700000 DOCA recipients just like her in the U.S., but the program? It was a compromise set up by executive order, not enshrined in law. And that’s why the Supreme Court could end up getting rid of it completely. Is the Trump administration is urging them to do. Dolly has been watching all this play out intently. Earlier this spring, as the covered nineteen outbreak was devastating the country, she noticed an unusual filing submitted to the Supreme Court. It was late in the game. Oral arguments in the DOCA case were heard back in November.
S2: You know, I know in April there were there was an additional submission of extra briefs that were provided to the Supreme Court in support of DOCA, especially in relation to.
S1: It was about people like you. It said 30000 health care workers are undocumented.
S2: Correct. Currently, 30000 DACA recipients work within the health care field in one way or another. And I know my name is one of the ones mentioned in these briefs. It brought a tiny bit of comfort to know somebody gave us a little voice by submitting that extra brief. And I’m just so thankful that there are people who are actively working on this and continuing to highlight all the efforts that are being done by Dr. recipients in this community, especially when we’re in the thick of it. You know, when when I’m in the ICU and I don’t have the time to think and say, hey, you know, we’re here, we’re fighting on the front lines and we’re caring for for these patients that are so sick.
S1: I want to talk a little bit about you and your story. When did you realize you had this undocumented legal status? Was it something you always knew growing up or was it something you learned?
S2: I came to the United States. I was born in Mexico. And I came last when I was 10 years old. And I was aware that we were coming from Mexico and that we came with a visa. But I didn’t know all the details. So it was until a little bit later when I was maybe in my junior high years when I would start to hear conversations with my parents saying what’s going to happen later if they if our children do want to go to college, if they want to try. Etc..
S1: When you overheard that, what did you think they were talking about?
S2: You know, I wasn’t completely sure. I remember thinking, oh, we don’t have certain papers. Well, I guess we can just go to some office and get those papers. It was it was always referred to as papers in this very broad sense. And I just imagine an office somewhere with just tons of papers. And when that we were going to go and get papers from this others. And as I grew up, you know, I definitely realized that it was much, much more complex.
S1: It was a lot more complex, especially coming from where Dolly grew up. She was raised in Arizona, a place where immigration has been a lightning rod issue for years. Dullea still remembers the fear she had as the oldest child caring for younger siblings, wondering if one day her parents would get deported, just not come back from a day’s work. These worries only ramped up in 2010. That’s when the Arizona state legislature passed a highly controversial recist bill. Was in college at the time. Still undocumented.
S2: Back when I was in college, I remember the passing of SB 10 70, which is the law that allowed police officers to ask about your immigration status if you were to be pulled over, for instance, while driving, which, as you can imagine, just stirred a lot of anxiety, a lot of fear in the immigrant community because you were driving without a license.
S2: I was I was driving without a license, and I knew it was a huge risk every single day. I remember thinking you have to be the best driver out there. You can’t make any mistakes. You can’t afford to.
S1: Did you ever get pulled over?
S2: I did. I did get pulled over. What happened? That was really quite the experience. I was driving. This was during finals time. I remember I was driving to my chemistry final. And right before that I was doing my usual routine. I dropped off. I was going to drop off my little brother at school. And I see one of the stop signs near his school. I ended up not making a complete or full stop at the stop sign.
S1: That ruling stop. We’ve all done.
S2: Correct. And there was a police officer who happened to see that. I did not make that full stop. You must have been terrified. I was. I was so scared. I just sort of thought, that’s it. I’m going to probably be deported from here. I imagined me, you know, being in detention center and my my little brother. So all three of my younger siblings are U.S. citizens. So he looked at me and he had this look of what’s going to happen to you. And I didn’t know how to answer him. But by that point, the police officer was also at my window. And, you know, sort of the three things that you’re always asked for or your license, your registration, your insurance. And, you know, I had two of the three. And he said, where is your license? And, you know, I sat there quietly for some time. And I remember thinking, how do I explain to him I don’t have one? I didn’t want to be dishonest, but I I was afraid that if I said, oh, I’m undocumented, that that would automatically start, you know, this proceeding of me, you know, going to a detention center somewhere and maybe being deported. I remember telling him I would really love to have a license, but I am not able to. And he looked at me a little perplexed, his head tilted to the fight. And after a few seconds, he went, Oh. And I thought hopefully he understood without me having to vocalize. Exactly. And he said, you know, you really have to be careful. You have to be more careful than anyone else. You can’t afford to make these sort of mistakes. He was honest. He said, you know, right now I could easily take your car away. I could easily report you to this agency. I can do all these things, which I’m not going to do, but I will give you a ticket for this and you’ll you know, you’ll keep your car. But I want you to really drive safe and to remember this. And I was so thankful, I was so thankful. I try not to cry in front of him. But the minute he left, I just started crying. I couldn’t I couldn’t stop crying. And I remember you telling myself, you have to compose yourself. You’re going to go take your final. Right now, you can’t stay. So I did. You know, I I gathered myself and I was able to go and take my final listening to you.
S1: I can tell that as a young person, you felt a lot of pressure because you were the oldest child in your family. You were the one undocumented child. Your parents had brought you to this country. Presumably because they wanted a better life. And did it feel like to you?
S2: Yes, definitely felt like that. Often people ask, what was your inspiration when things got really hard? What kept you going? The answer always is my parents. I saw my parents work incredibly hard from such a young age. At times I remember my dad having up to three jobs and he would go straight from one to the other. He woke up before the sun rose and often came back after it had set. And my mom was very similar. You know, she would go to her job and then come home and do the cooking and and make sure that we were doing okay in classes. And I remember looking at all that sacrifice and thinking I have to do my part. And I thought the best way I can do my part is by being the best student you can be.
S1: Did you always know you wanted to be a doctor?
S2: It was something that was definitely in my head, but I think it didn’t really cement and so fully formed itself until I was in college. There was a lot of things that inspired me being curious about medicine in Mexico. I remember that the best way that people could go and seek medical help was through a small clinic or a Red Cross clinic that we had access to. And if we needed care, that was beyond that. The nearest hospital was one hour drive away. And I wondered why. Why is it so far? Why don’t we have doctors here? Why is this so hard to do? When I came to the US, you would think of all of that changes and all of that goes away. But it didn’t go away. I grew up in neighborhoods where people still couldn’t go to the doctor because they couldn’t afford to have insurance. They couldn’t afford to make payments to see it, even just a primary care physician. So a lot of those disparities mirrored some of the things that I that I saw in Mexico. And again, I kind of just I kept having this feeling of it. It has to change. It has to be better. We can do more.
S1: Did you worry that your immigration status would make it harder to go to medical school?
S2: Absolutely. I remember thinking or saying to people, I want to be a doctor and I want to go to medical school. And they would ask me, how how are you going to do that, would you say? And I would say, I don’t know, but I’m going to do it.
S5: And it was it was maybe very naive optimism, but there was optimism. I did not want to let go of. And I would lay a home in bed thinking, how how do I make this happen? Do I.
S4: Email medical schools to tell them about my situation at the time, the idea of getting into grad school or a medical program undocumented, it seemed like a mountain that was just too high to climb. The schools might not want to take a risk on Dolia or she wouldn’t qualify for scholarships. But then some luck came her way.
S5: And then in June of 2012, DOCA happened.
S6: Effective immediately, the Department of Homeland Security is taking steps to lift the shadow of deportation from these young people over the next few months. Eligible individuals who do not present a risk to national security or public safety will be able to request temporary relief from deportation proceedings and apply for work authorization and at the time.
S2: President Obama passes this. And I remember looking at this and saying, this is it. This is going to be the doorway to the next step. This is my chance, right? This is my chance. And I was definitely scared. A there was a lot of questions about DACA as a program at the time.
S1: Some context here. One of the critiques of President Obama back then was all the deportations happening under his watch. So you can understand why some undocumented immigrants like Dalia might not have been very eager to tell an administration that was deporting millions of people. Hey, I’m undocumented. Here’s my address. Put me in a database.
S2: It was definitely a little nerve wracking to to apply. And it was something that I spoke to my parents about at length, because if anything, they told me maybe hold off and wait to apply a little later until we know a little bit more about this program and whether it will last and what the true intentions of the program will be. And I sort of said, you know, I think I just need to go for it. I, I know there’s risk here, but I don’t want to miss this chance. And, you know, ultimately, they respected this decision. And I went ahead and applied. And I was very lucky to think that turnaround time was a couple months when I received. Card in the mail. And the third deck, you have some protected status of being protected two years at a time. And you have to continue to reapply. I knew it wasn’t a permanent solution for those two years in front of me. I knew I had two things. I had protection from deportation, which is the first time I could sigh that little bit of relief and say, I don’t have that cloud over my head. And at the same time, I can actually work now.
S1: And that’s exactly what Dolia did after she graduated document. She could get a job as a lab technician. Then she saved up money before applying to just 10 medical schools. Most people play dozens of medical programs to boost their chances of admission. But don’t you couldn’t afford it?
S2: I know. I just sort of told myself I hope one of these 10 is interested in me and that they give me a chance to even just interview. Little did I know in this whole process that the first school who would offer me a secondary application was Harvard Medical School. And it was also the first school to offer me an interview. And the first school to give me an acceptance letter.
S1: Oh, my gosh, I.
S2: I would have never imagined that would be the trajectory. And if somebody would have told me, I would have said, you’re lying.
S1: What do you tell your parents?
S2: At the time, I remember only my dad was home and he was cleaning the pool in their backyard. And there was he was trying to get something out of it. And I went to the back yard and and told him, hey, dad, I just got accepted to Harvard. And he said, what? And automatically dropped the pumpkin back into the pool, which he later had to go fishing for. But he just he became so teary eyed and just walked over and hugged me right away. But I think we both knew at that moment that this was just a culmination of so many things, you know, of incredible sacrifice, not just by me, but my whole family. My community is just so many years of having to overcome struggle after struggle. And then you have this one person who is given this chance. And I think it’s a win not just for yourself, it’s a win for everyone in that community. And that’s definitely how I saw it. I remember thinking I have a chance to represent where I come from now and to represent all these voices that that do live in the shadows, to represent all these patients who don’t have a doctor that looks like them. I have the chance to to give all these people a voice.
S1: Dullea was the first DOCA recipient to gain admission to Harvard Medical School. She thrived. After graduating, she became a resident at one of Harvard’s teaching hospitals. That’s where she’s been working on that Cobbett unit. Your biography is is really moving. Like I just listening to you talk, I have almost cried twice. Your story. It’s become one of those stories politicians tell to make a point like Senator Dick Durbin brought a big picture of you onto the floor of the Senate and spoke about how far you’d come.
S7: Balya graduated high her high school in the top one percent of her class. She was named the most outstanding life science student at the school. Not only did she excel academically, she completed over hundred and fifty hours of community service. This is a remarkable young woman.
S1: She started after school. And I wonder I wonder how you think about that. Because it’s wonderful in some ways, and then it’s also more of that pressure that you felt when you were a kid to be perfect.
S2: Right. When you kind of become the poster child, quite literally, for, you know, the sort of conflicting emotions that are running through you. And you kind of want to say, you know, but what about my peers who didn’t make it? Why aren’t their faces here? You know, like, I want their faces there, too. And I’m not any better than any one of them. There are many colleagues. I had actually in college who dropped out, never graduated, never finished because they couldn’t pay, because they became scared when SB 10, 70 was implemented. And in a way, I’m glad that that story was shared. But at the same time, I think of all the stories that were not shared, not the stories that didn’t make it. And I think that’s some of the reasons why I still keep talking about this issue, to keep highlighting them.
S1: We started by talking about the Supreme Court decision that could come out any day now. The court doesn’t really give any good indications of when it will rule. We just know that they’ve been ruling on Mondays and it could come at any time. Do you get nervous before decision days?
S2: I do. Again, it’s just something I kind of I mark in my head. I’m aware of. I tried to sort of prepare myself if I happened to, you know, go through my phone and look at the news. I tried to tell myself, you know, don’t be too surprised if you see a headline somewhere that has a decision. But at the same time, I’ve I’ve learned to sort of market and and just tell myself it’s OK. Be at peace with it. Now, it’s not something you can control this moment this instant and go on with your day and do all the things that you’re supposed to do today.
S1: Do you have a plan? Depending on what the justices say. What do you think about. What you do if the program vaporized?
S2: You know, I don’t have a good plan. I wish I could say, you know, these are all the things I plan to do, but I don’t have something firmly. I think, you know, for a long time, a lot of talk at recipients. I felt that we’ve needed a long term solution to this issue. If it does so happen that this program disappears, that the ruling is not in our favor. I think this will put tremendous pressure on Congress to hopefully act to put something together that gives us something more, that is more long term, and that puts us hopefully on a path to citizenship or to some sort of adjustment of status, because living a life like this two years at a time is full of anxiety, full of uncertainty. And I think this community deserves some peace.
S1: When do your two years run out?
S2: My permit expires January of 2022.
S1: So you have time.
S2: It’s not a lot of time. And in a way, you know, I. I know that I’m answering this the same way I’ve answered all the other questions, big questions in my life. How are you going to go to college? How are you going to go to medical school? How are you going to continue residency?
S5: I don’t know. But my naive optimism is in me and I will continue to do everything that I can to push for this issue, to work with individuals, hopefully that do have the capacity to change things, because I think it is this merits change long term change.
S4: I have to say, given your story. I would. I’ll bet on you. I’ll bet on you figuring it out.
S2: Dalia, thank you so much for joining me. Thank you so much. This is great.
S4: Dr. Dalia Larios is a medical resident working in Boston. And that’s the show. What Next is produced by Mary Wilson, Jason de Leon and Daniel Hewett. Special thanks to Allison Benedikt and Alicia Montgomery. I’m Mary Harris. We’ll be back here tomorrow with more. What next?