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Ep. 37 — A tumultuous childhood filled with displacement and abuse draws a healthcare expert to the psychology of human behavior / Nicole Fisher, President of Health and Human Rights Strategies.
To say that Nicole Fisher’s childhood was tumultuous would be an understatement. Fisher’s world fell apart when she was two years old when she began to experience a pattern of psychological, and physical abuse by her mother.
When her parents divorced, her dad won custody of Fisher and raised her with the help of loving relatives. But Fisher still endured years of brutal custody battles in which the courts often sided with her mother and ordered Fisher to visit her or even live with her, creating massive stress and uncertainty, fueled in large part by her mother’s unpredictable behavior.
“There were many times, she was so loving, and kind, and affectionate, and there were other times she was the opposite. And I think that actually at its core, is part of that underlying instability,” say Fisher. “It wasn’t just, whether my grandma was picking me up from school, or my aunt, or I was going to walk home with cousins, I think it was really, not knowing which sort of personality you were going to get, and that instability . . . really created a need for me, to have predictability in my life, and to understand, why, what were those triggers, what was within my control, what wasn’t.”
Her chaotic childhood left Fisher with a deep hunger to understand the human psyche. She has devoted her career to working on issues of health and human rights, homelessness and hunger through her consulting firm, Health and Human Rights Strategies.
Fisher soon realized that the poor and underprivileged in the U.S. confront many of the same issues as those in the developing world. This chasm between the haves and have nots in America has only come into sharper relief with #Coronavirus.
In a strange way, the #Covid-19 pandemic has brought Fisher full circle to her own history of displacement, and resilience.
Transcript
Chitra Ragavan:
Nicole Fisher’s world fell apart when she was two years old, and she began to experience psychological, and physical abuse by her mother. Fisher’s dad worked three jobs, and despite his best efforts, had little idea how to bring up a daughter, but he had the help of her grandparents, and many other relatives. Her chaotic childhood left Fisher with a deep hunger to understand people, and a passion for health and human rights. Hello everyone, I’m Chitra Ragavan, and this is When it Mattered. This episode is brought to you by Goodstory, an advisory firm helping technology startups, find their narrative. My guest today is Nicole Fisher, President of the consulting firm, Health & Human Rights Strategies. Fisher is a global health and policy contributor to Forbes, and the founder and curator of the think tank, A Seat at the Table. Nicole, welcome to the podcast.
Nicole:
Thank you for having me.
Chitra Ragavan:
Well, to say that you had a rough childhood, is a bit of an understatement. Tell us what happened.
Nicole:
Sure. It’s not something I talk about very often, but yes, my childhood was, I think tumultuous, is a word. I had a wonderful family, a very big loving family, but my parents got divorced, for good reason, when I was very young, and there was, as you mentioned, some psychological and physical abuse. It went on for years, and so my dad got custody of me at two. We moved to be near his family. I was born in Louisiana, but we moved to Missouri, where his family was. And over the years, there were lots of custody battles, lots of court dates, lots of instances of having to choose which parent to live with. I of course chose my father, but the courts’ system really believed, particularly back in those days, that children, girls in particular, should be with their mother. And I respect the mindset, and yet we had a loving… My father is the greatest guy in the world, his family is just so kind and warm, had no problem, helping to raise and step in when he needed help.
Nicole:
And yet, kept having to strike this balance of being sent to stay with her, or live with her, and then either getting dropped off, and being left and, or my dad having to come get me. It was just constant motion. In fact, I joked that I used to go to school, at least every third day, because my father was a fireman, with a backpack, and a duffel bag, an overnight bag, and more nights than that, just because whoever dropped me off in the morning was not who I was going to be leaving with at the end of the day. So I grew up in a very hectic sort of lifestyle, and yet I think I can say, with complete honesty, that it had lots of pieces of normalcy. My family and like I said, was very close, and they all lived in one town. So I had the opportunity to be very close to lots of aunts and uncles and cousins.
Chitra Ragavan:
Well I guess you did have that village.
Nicole:
Yes. I think that actually, when I think about my childhood, I think that saying is the perfect application. It took a village.
Chitra Ragavan:
So you saw your mother often, even though there was this physical abuse, and you wound up going to court a bunch of times when you were young, for these custody wars?
Nicole:
We did. I don’t remember all of them, and there were obviously instances they didn’t involve me, but I seem to recall my dad once saying something about, they had gone to court, maybe 14 times, by the time I was seven or eight. It felt, as a child, like it was just constantly something that hung there, and I never really understood, why? I couldn’t understand that need to fight. I think it was really about winning, I don’t think it was about providing care, or wanting to have a child around all the time. It felt much more, like it was simply a matter of, “I don’t want you to have her.”
Chitra Ragavan:
And when you went back, I guess on weekends and stuff, to see your mother, did you still experience abuse? What were you getting when you went?
Nicole:
It depended. There were many times, she was so loving, and kind, and affectionate, and there were other times she was the opposite. And I think that actually at its core, is part of that underlying instability. It wasn’t just, whether my grandma was picking me up from school, or my aunt, or I was going to walk home with cousins, I think it was really, not knowing which sort of personality you were going to get, and that instability created… you alluded to this in the introduction?I think it really created a need for me, to have predictability in my life, and to understand, why, what were those triggers, what was within my control, what wasn’t. And I also, had a psychologist when I was younger, probably 10 or 11, who was fantastic. And that was something that I remember her very vividly working with me, to understand, which was, “There are adult things I cannot control, and there are things I can control.” And at that age, there’s not a lot you can control.
Nicole:
And so, when things happened, to go within myself and say, “this is not something I have the ability to change, it’s sort of a live-through-it, you can’t go around it.” And I’m very thankful again for an outlet, that gave me resources, and helped me understand the best of my cognitive ability at the time, what was happening around me.
Chitra Ragavan:
Was there any one day or any one event or anything that kind of best summed up the chaos of your surroundings, and how you coped with it?
Nicole:
To be honest, I don’t know that I had one coping mechanism, and if I did, it was… I’m still guilty of it today, over committing. What I took to doing very young, was committing myself to as many things as humanly possible, so that I didn’t have to be home. Or I had to be at a practice, I had to be at a lesson, I had to be cleaning my room, for this or that. I always found things to do, to keep myself busy and occupied, so that there wasn’t free time, for conflict to arise.
Chitra Ragavan:
So what was your ultimate path, out of the situation?
Nicole:
Well-
Chitra Ragavan:
College I guess?
Nicole:
… I think that’s really it. I think I knew at a pretty young age, I was not going to be a professional athlete, or a professional dancer, or singer, or any of those things. And although no one in my family had finished college, my dad was adamant from the time I was very, very young, that I would go to college, and that was going to be my future. I didn’t plan to be an academic at all. I thought I would be some kind of doctor, but I knew, when looking at my horizon, that school was going to be an anchor in my life. And so I worked very hard, and luckily I love reading, and I’m a very, very curious person, and so school was something I threw myself into, but I also enjoyed. And so when I turned, I think 18, and my birthday falls right at the end of the school year.
Nicole:
As I was in the last month or two of school, graduating, moving to college, I made the decision to end that relationship. I knew I was moving away, and I wanted to start college fresh. And I didn’t have it all figured out by any means, but I did know, there were certain aspects of that pre-18 youth childhood, that I just didn’t want to take with me, into that next phase.
Chitra Ragavan:
So then how did you get your life together? What did you end up doing?
Nicole:
Is it really ever together? Life, I think for me became, as predictable as humanly possible. And I did that in a number of ways, particularly, looking back, it’s very obvious the patterns that arose. But before I even finished college, while I was psychology and biology major, I wanted to understand human behavior, I wanted to understand people. I thought I would end up in neuroscience, but before I graduated, I had already applied, and been accepted, that’s going to get a Master’s, and the same. Before I finished the Master’s degree, I had applied and I was headed to a doctoral program, and so I ensured that at least, on the academic front, I always knew a year in advance what was next, where I was going, what I would be taking, I tried to make the pathway as smooth as possible, and I think I did the same in my personal life.
Nicole:
I was very fortunate to have met a man very young, I guess early, twenties, and we were together. We did all the right things, I guess if you want to say it that way. We dated, and got engaged, then married, bought a house, all those responsible things, and I think now, it’s really easy to see looking back, that from 18 to mid-twenties, until late twenties I was doing everything in my power to keep life, as stable and predictable, as humanly possible. All those things I couldn’t control, I was trying to control.
Chitra Ragavan:
And then it fell apart.
Nicole:
And then it fell apart.
Chitra Ragavan:
So what happened?
Nicole:
Well, within a short window of time, I was nearing the end of my doctorate, and my husband and I decided to get divorced, and my dissertation chair passed away. We knew it was inevitable, but once his cancer came back, it was pretty, pretty rapid. And so I realized within a few months window, I had no idea, what the hell I was doing, personally, or professionally. I decided to see if all the time I had spent in school, becoming, this thing, obsessing over neuroscience policy, the healthcare system, I decided to go see, if I could do it. And I just walked away from everything at once. And actually, I literally walked away from everything at one time, I moved to D.C, and I got a tiny little place in a basement, and the healing of sorts started.
Chitra Ragavan:
But that must have been pretty bleak, to be in that basement and to recognize that you were back to square one.
Nicole:
Oh, it felt like behind square one. I think square one would have been a really great starting place. I think at the time I believed, I was at square one, but in retrospect, no I wasn’t. And I think that was really nice, a couple of years later, when I left that place, and got this beautiful tiny apartment, but it was all windows. I remember thinking how spectacular it was that I was, I had to spend a couple years in the basement, figuring it all out, putting the pieces together, my head down. And then when I was ready, look at all this sunlight, look at floor to ceiling windows. Who knew? And I thought my housing situation, very nicely paralleled, what I was going through. And it was unintentional but lovely.
Chitra Ragavan:
How did you rebuild your career?
Nicole:
Well, I don’t even know whether it was rebuild. I tend to think of it… I frame it a bit differently, and that is, I think to get to where I am now, it took all the pieces. It’s kind of like a toolkit. I think the years of education in one area, I built up a lot of skills and tools. I think in doing a master’s degree in policy, I brought in another set of tools. I think that move, the doctoral work, and the move to D.C. I knew I was resilient, but again, I think that’s a skill set, and I don’t think it’s a skill set I had applied in several years. And so by the time I started to think about my career, my future, I think what I was doing was really pulling all those tools together, and actually starting. So in a way it kind of looked like a second act, but I really think it was maybe the first act, the first time I was doing the things I wanted to do.
Nicole:
I also had some wonderful mentors, who took risks in allowing me to do writing, to speak, to take on some projects, I worked relentlessly, but without those advocates, and those mentors, opportunities aren’t just available, particularly in places like Washington D.C. And so again, it kind of took a village, but I love the way, all my previous experiences and tools came crashing together, and I found where I knew I was really happy. And then even if there wasn’t a paycheck attached, my heart was happy and whole, and I felt full.
Chitra Ragavan:
What fulfilled you the most? I know you were traveling a lot abroad and you were doing a lot of work in developing countries at the time.
Nicole:
Yes. I know it sounds really vague, to say helping people, but I do find that when I help, and in particularly on a broad scale, I don’t need recognition, I don’t need to be the leader, but just the knowing there’s been improvement, live’s got better, healthier, longer, those sorts of things, like I said, they make my heart come alive. And those first few trips, I think it was really difficult to come home, to be honest. I think because so much had happened here, and like anyone, we’re all human, we all get caught up in our own day-to-day. To sort if just pause, and take two months and go work in clinics in India, and Nepal, and other places where I first started, it got me out of not only my day-to-day, but the day-to-day issues I was dealing with.
Nicole:
For example on Capitol Hill, even with the Affordable Care Act, what we were really doing, was debating insurance reform. And so, to stop that daily, put on a suit, and go talk about… shuffling pieces of paper around, I was literally, sleeves rolled up, as they say, working in a system, trying to teach people the absolute basics, trying to work through all kinds of barriers that exist that, we in the U.S don’t think twice about, because they’re not the kinds of problems we deal with. And that is where I think I started really seeing what my priorities were, and that actually, many of those problems that I was dealing with overseas, they’re right here in the U.S. I just had to open my eyes a little more, and I had to have more experiences, and I had to see how, in many ways, they’re the same, they just look different.
Nicole:
We have lots of food insecurity in this country. There are plenty of children that do not know where their next meal is going to come from. There are plenty of homeless, unsheltered. There are still unbanked people in the U.S. People who do not have bank accounts, meaning they don’t have access to so many other things. So to see how those problems are being solved, from tiny villages, to major cities like Dhaka, and bring those skills back, that was where I started to really find that sweet spot of, how do people behave, and how do the healthcare… all the other systems work? And then, how do we invoke change, that actually meets people, where they are and isn’t just a bunch of people in an office, talking to each other about their problems.
Chitra Ragavan:
And you’re kind of seeing a lot of those problems laid bare now with the coronavirus pandemic, including here in the U.S., and it feels like all of the work you’ve been doing, all of that resilience you’ve built, everything you learned, is allowing you now to understand, the psychological, and other barriers here, with this huge threat that we’re facing. How do you see that?
Nicole:
Well, the timing, particularly, of us having this conversation, couldn’t be any better. We are in the thick of it right now, and I believe this is a problem, the coronavirus in particular, I think it’s something we’ll been dealing with, a little bit longer, than the timeframe we’re giving people. Just, I think because of the nature of the virus, and the number of people, age, and the previous underlying health conditions, I think there were probably cases that we didn’t recognize, the flu season this year has been exceptionally bad, and so I actually think that, it’s a problem we’ve had longer than we’ve known. That said, when it comes to, these underlying issues, when it comes to access to care, when it comes to things like infectious disease. The truth is, are we seeing something different? Yes, are we seeing something different? No. I would guarantee that anyone who works in global health, can give you a list of 20 different examples in the last 100 years of things that we’ve been dealing with, from Zika to Ebola to honestly the flu. Influenza A, in particular this year, it kills a lot of people.
Nicole:
And so being able to have any kind of impact in that space, again, whether it’s prolonging life, improving life, it feels good, it also always feels like, you’re plugging one hole in the dam, and the whole thing could break at any moment. It can be very fulfilling, and very frustrating, at the same time.
Chitra Ragavan:
You also have a framework for thinking about the coronavirus in terms of behavioral change, just because of your deep interest in human behavior. What is that framework, in terms of how people make decisions?
Nicole:
Well, I think the starting position of thinking about any framework, is that people are not rational. We are rational, but only in the sense of what is in front of us, and what we’re dealing with, at the time. And so when I think about how to make even small changes, in a particular clinic, all the way to, how do we lay something out at a country level? It really comes down to meeting people where they are mentally, where they are emotionally, where they are physically, obviously geographically, but also where they are financially. There’s a lot of circulating rumors, going around here in the U.S, and in all over the world, about quarantines, lockdowns, those sorts of things. And I believe you always try and play out as many unintended consequences, as you possibly can. You don’t want to waste time in unlimited scenarios, but you know how people are going to behave, when you do something like lock them down.
Nicole:
There are plenty of parallels to prison, it’s something you do to people, without necessarily engaging them. And when that happens, people react. We saw it in Liberia with Ebola, people protest, they riot, and in cases like this, when you don’t want people, congregating and spreading a highly infectious disease, we have to really think through some of those answers, that at face value, may be very simple like, “Well, if we tell everyone to stay at home, and they don’t have a choice, they won’t spread the disease.” That’s not how it works. People don’t necessarily take kindly, particularly Americans, to being told what to do. Certainly not with threat, military force, and we find other ways. We’re human. We always find ways around the system.
Chitra Ragavan:
What about the whole social distancing phenomenon?
Nicole:
I think had I been consulted, about how to communicate, what we need people to do, I would have done it differently. I think social distancing makes sense to people, at the same time, I think it misses the mark. I would have branded it something like, physical distance, social connection. We live in a world of unlimited possibilities for connection. There are social networks. We can socially connect in so many different ways. But it’s the physical distance, that we need, to stop, the transmission. And so I think, there is a bit of a missed opportunity there, to get buy-in from people, and to get them to understand, and participate, because if you tell them they have to be physically distant, but you need them to socially connect, I think there’d be a lot more compliance, and voluntary compliance with what you’re hoping for.
Chitra Ragavan:
There’s unprecedented disruption because of coronavirus, particularly in children’s lives. Schools are closed, colleges are closed, and we’re all dealing with that as parents, and having children. You grew up in a state of constant chaos, disruption, unpredictability, to the point that, you didn’t know which house you are going to be in, or what porch you are going to be standing at, what advice do you have for parents who are now dealing with these disrupted lives, for themselves and for their children?
Nicole:
First, I would say cut yourself some slack. You, we, are all in a place that we didn’t plan for. All of our lives have been disrupted, many people have a lot of competing demands at the moment, that involves spouses and children, and activities at home, work, so be kind to yourself. Give yourself a break. But beyond that, I think it’s important for parents, to do the things we’ve been talking about, up until now. Children thrive with predictability. Their brains aren’t finished developing until their mid twenties. And so any change to their structure, causes them all kinds of conflict. And it’s not their fault. They’re children, they’re going through change, it’s going to disrupt their routine, and that is going to be expressed. It’s going to be expressed in different ways, depending on the child.
Nicole:
Their brain is literally in real-time, trying to process something, that we as adults are struggling to process. And so I think it’s important for parents to also be gracious towards their children. They’re struggling, and that’s okay. This is what builds resiliency. Kids are so resilient. They’re going to get through this. They’re going to learn, they’re going to adapt. That’s what they do better than we do by far, but, give them a bit of leeway. They’re trying to figure out a new state of the world, and state of the state, and that is really difficult for them, until there’s a routine, that makes sense.
Chitra Ragavan:
Given your knowledge of the U.S. health care infrastructure, and the bureaucracies, and the limitations, as well as the strengths, what are your biggest concerns, and what do you think needs to be done to get us past this crisis?
Nicole:
I cannot speak for all Americans, certainly. But I feel as though I can answer that much better domestically than globally, because every culture is very different. But, domestically, I think if we’re not there yet, Americans are going to reach a place in the very near future where, the politicization of this virus, is going to be exhausting. Politics has brought us to a point… the division in the country has brought us to a point where people are exhausted, they tune out, or they’re very quick to anger, they’re very quick to taking up sides, and arguing, not listening, and when it comes to something like a virus, it has no political party, it has no color, it has no differentiation at all, about your income level, your geographic location.
Nicole:
And so when people are hungry for information, and I think it’s safe to say, the faith that Americans have in their institutions, academia, science, unfortunately, politics, that’s been eroding. It’s been eroding consistently for years. And in a situation like this, I can’t imagine a worse scenario, than people not trusting the experts, who have been put into place. And the longer, the political theater goes on, I think the more upset Americans are going to get, that they’re not being fed the information they need, to take care of themselves, take care of their families, take care of their neighbors, and loved ones, and communities. And so, I hope one of the positives to come out of this, is that people will connect with those around them, and that they will demand, that the government has to start putting the American public… that’s why it’s called Public Health, above partisan politics. Because it’s doing so much damage to the message, to resources, and we’re all going to suffer because of it.
Chitra Ragavan:
Looking back at that two year old girl, and that eight year old girl, who was in family court, 14 times, and who didn’t know where she would be sleeping every day, or waking up every day, and looking at where you are today, and the work that you’re doing, what would you say to that child, and to that young girl about how your journey and where you’re going?
Nicole:
Oh, I don’t want to cry. I think first, I would tell that young person, all the things that happen in life, learn from them, roll with them, adapt the word we used earlier, resiliency, will get built even in the hard times, and what doesn’t kill you, will make you stronger. And all those lessons learned, will make you better, at what you want to do, when you’re older, because I think to a fault, at times, empathy is something that just runs very deeply inside me. Like I said to a fault… sometimes I get really caught up in certain… well, you mentioned coronavirus. This is a great example of… I think it made quite a few newspapers, that New York was struggling to decide whether they should or should not close schools, due to the sheer number of young people in New York schools, that do not have a home, or a home that is stable, or food. And they kept the schools open additional days, just to feed children.
Nicole:
And in those types of situations, my empathy can get the better of me, because it’s frustrates me to no end, and it makes me angry, to know that we have solutions, there are resources. If we can feed people in other countries, if we can make clean water on island nations that have absolutely no access to clean water, if we can do it there, we can do it here, and we should. And we should be able do it easier, faster, better. And so I get very passionate about those sort of underlying human rights issues. And they’re very complex problems. They can take up a lot of space in your head, trying to work through and around them, but I would tell her that, it’s all going to be useful in the future.
Chitra Ragavan:
Did you, I know you said you haven’t been in touch with your mother since you were 18, did you ever tell her the hurt that she caused, physically and psychologically, and will you ever?
Nicole:
I did to the best of my ability. Very few people in the world know this, until now. When I decided I was finished with the relationship, I wrote a letter, and it was very lengthy, writing in front and back pages, I was a teenager, and I just started writing all the things I remembered. I think it was very cathartic for me, so that even as I got older, I knew… again back to the empathy. I knew I would question the decision, and I always felt like I knew I would want a mother, I felt like it was unfair, that I hadn’t gotten one, that will be the kind of one I should’ve probably had, but I took that letter, that was just basically a laundry list, of the things I remembered having done to me, and I put it in an envelope, and I left it under the windshield wiper on her car, and that was it. I really had to close that chapter.
Chitra Ragavan:
Do you know if she read it?
Nicole:
I assume so, based on something she said to my younger sister, much later in life. My sister conveyed something to me that, my takeaway was it was read.
Chitra Ragavan:
Well, Nicole, thank you so much for joining me today, and for sharing your amazing story, I really appreciate that.
Nicole:
Thank you. Thank you for having me. I’m sorry I’m a little choked up. I’m very good at observing and trying to explain to other people’s behavior, but reflecting on your own, sometimes, very necessary, and yet makes you explore things you don’t often explore.
Chitra Ragavan:
Well, thank you very much.
Nicole:
Thank you. I appreciate you and I appreciate this podcast, and I’m amazed at the number of absolutely incredible people that you get to open up and share their adversity, because it really is the way forward.
Chitra Ragavan:
Thank you. Nicole Fisher is president of Health & Human Rights Strategies, her Washington, D.C. based consulting firm. Fisher is a global health and policy contributor to Forbes, and the Founder and Curator of the think tank, A Seat at the Table. This is, When it Mattered. I’m Chitra Ragavan.
Chitra Ragavan:
Thanks for listening to When it Mattered. Don’t forget to subscribe to the show on Apple Podcasts, or your preferred podcast platform. And if you like the show, please rate it five stars, leave a review, and do recommend it to your friends, family, and colleagues. When it Mattered, is a weekly leadership podcast produced by Goodstory, an advisory firm helping technology startups with strategy, brand positioning and narrative. For questions, comments, and transcripts, please visit our website at goodstory.io, or send us an email @podcast@goodstory.io. Our producer is Jeremy Corr, Founder and CEO of Executive Podcasting Solutions. Our theme song is composed by Yagerline. Join us next week for another edition of When it Mattered. I’ll see you then.