I met Eliza Ramos at a ServiceSpace circle of sharing for individuals involved in healthcare. I sat in on the circle because I knew that each person I’d meet that afternoon would be doing inspiring work. I was already aware of two of the people who would be there: Dr. William Stewart, co-founder of San Francisco’s Institute for Health and Healing and author of
Deep Medicine, and Dr. Grace Dammann who had been so involved working with AIDs patients before anything was known about the disease. Years later, against all odds, Dammann survived a horrific auto accident and has gone on to new levels of inspiring work. (Her remarkable story has been documented in the film “States of Grace.”) That afternoon, many other inspiring stories came to light. Two hours in, most of the people in the circle had spoken and then a quiet woman, Eliza Ramos, began telling her story. I found it both astonishing and compelling. Afterwards, I approached her and asked if she'd be open to an interview later on.
I also met Eliza's partner, Joseph Scarpelli. I'd learned he was part of an organization another remarkable doctor, Sri Shamasunder, had co-created - HEAL or Health Equity Action Leadership. When we got together a few weeks later to talk, I began by asking her about that...
RIchard Whittaker: Are you officially part of Sri’s Health Equity Action Leadership?
Eliza Ramos: No. I’m part of the fan club.
RW: And Joseph is part of that?
Eliza: He was their first hire. Sri and Dr. Phuoc Le were the co-founders. So I’ve been watching them grow over the years.
RW: Okay. Let’s start with what you’re doing today. Would you say a little about that?
Eliza: I work for an organization called Circles International. Our mission is to cultivate wellbeing and prevent burnout for leaders working in social impact. We operate under the belief that leaders working in social impact and social justice also need to be supported and sustained in order to do the best work they can.
There's a culture, especially in social justice work, of service—which is so important. But we help people explore the question of what does it look liketo integrate ourselves
into that service and realize that we have to be taken care ourselves in order to be effective in the work we do? How does one prevent burnout? So we partner with different organizations and do consulting work, mostly for staff, around well-being and burnout prevention. I started it a couple years ago.
RW: It’s your foundation?
Eliza: Yes. I never expected to do something like that [laughs]. I just kept having so many conversations around this need.
RW: It's always interesting when someone starts something of their own. What sparked this? You must have understood the need for something from your own life.
Eliza: Yes [laughs].
RW: What would you say about that?
Eliza: My parents have always been very service-oriented. I grew up with that sense of the importance of community and service, and I quickly went into social work and public health. I was a social worker for a few years and I just found myself burning out job after job. I’d just say, “Oh, it's probably the job. It's probably the stress.” And I'd go the next job. Then the same issues would come up and eventually I got to the point where I got so burnt out. I think my body caught up with me. I was living in Rwanda at the time. I started getting a lot of severe back pain and also having a lot of mental health issues—anxiety and depression symptoms, and I was starting to isolate myself. The work I was doing was around HIV and child malnutrition and I was just witnessing so much grief and pain on a day-to-day basis.
RW: What got you to go to Rwanda in the first place?
Eliza: I was burning out job after job, and I thought, “Oh, I’ll go across the world!” [laughs]. I mean, I’d always been interested in other places. My mom is Sri Lankan-British-Filipino; my dad is Malayasian-Chinese-Spanish and grew up in the Philippines. So I’d always been interested in the world and also in the inequality in the world. So I knew that at some point I wanted to move to another country and do Public Health work.
RW: Where were you born?
Eliza: I was born in California. We lived in San Diego. But I grew up in a suburb of Portland Oregon called Beaverton, around mostly all white people—so that is a whole other conversation. Anyway, I grew up with this notion of inequality and wondering what the rest of the world was like. I was really curious about that.
RW: So in Beaverton, were there any other people of color?
Eliza: Maybe 5% to 10%. But it was also interesting, the inequality in my school. There was a pretty large Mexican immigrant population, but in the Advanced Placement classes, I was probably one of the only people of color.
RW: What were some of the issues you met in high school—or even earlier?
Eliza: My parents did a really good job of instilling in us that we could do anything we wanted. They taught me that difference didn’t have to be a bad thing. I didn't realize how much of a gift that was. Then in college, and after college, I started to question how the world is and how that compared to the world view that I grew up with.
RW: Would you say more about that?
Eliza: I went to USC. I had a hard time adjusting at first. I started working with a lot of Mexican immigrant families close to the campus. I started working with a lot of those families and that’s when I really got into questioning the inequality. I was on this beautiful campus with a lot of people coming from wealthy families and then you literally cross through the campus gate and you’re in this whole other world of East LA. There’s poverty and violence and kids dropping out of school. I worked with this organization called Troy Camp that I got very involved with. They work with kids in the local area; they take them to a summer camp and do in-school and after-school programs. But there’s a lot of adult stuff those kids have to deal with on a daily basis. …
RW: This was sort of your initiation, meeting these kids and hearing their stories?
Eliza: Yeah. I started as a counselor and then ended up being the executive director of that organization.
RW: Wow. So all this was connected with your studies?
Eliza: Yes, studying child psychology. I loved watching kids develop.
RW: So you were meeting primarily Mexican immigrant children near campus.
Eliza: Yes, mostly. Some African-Americans, and other immigrant families. Then after college, I moved to Mexico.
RW: Right after you get your BA?
Eliza: Right after.
RW: Oh, really? Boom! Where did you go?
Eliza: I lived in Oaxaca.
RW: Were you on your own?
RW: That's brave!
Eliza: [laughs] Looking back I wonder, “What was I thinking
?” But I was so
yearning for it. I was so curious about the world. Yeah. It was a little crazy at the time, because I didn't know Spanish. I just moved. I found a woman to take me in, Ruth.
RW: How did that happen?
Eliza: I was contacting everyone I knew when I was still at USC.
RW: She was an ex-pat?
Eliza: No she was from Oaxaca. She had a spare bedroom. She knew a little
bit of English [laughs].
RW: Okay. So what happened? How did you get to her house?
Eliza: So there was a man I got connected to, through a friend of a real-estate client of my mom’s, who is American. He was super kind and he picked me up at the airport and brought me to her house. There were people along the way who helped me the whole time.
RW: That's great. So you got there. So how long were you there in Mexico?
Eliza: I was there for almost a year. I was working in a few different villages doing health education.
RW: Was this on your own, or did you have some kind of NGO status?
Eliza: I got hooked up with an NGO in Mexico. At one point and I end up working in prisons in Mexico with groups of people who had addiction issues. I didn't know what I was doing! [laughs]
RW: That’s fascinating. Well, you were following something, searching and following, right?
Eliza: I guess so. It's funny talking about this stuff because I don't think about it too much.
RW: Well, your story amazes me. Like I would never dream of just heading out to live in Mexico, especially not speaking the language.
Eliza: When I look back at it, I’m surprised that I did that myself [laughs].
RW: What are some of the memories that really stay with you?
Eliza: I remember the first group of incarcerated men that I worked with. I was really nervous.
RW: By then had you picked up a little Spanish?
Eliza: By then, yeah. This is maybe six months in, and, by the end of my time with them, I think it opened my eyes to the complexity of people. These were men addicted to various types of drugs who had done various sorts of crimes—really hard humans. And at the same time there was one guy who crocheted a little bag for me with my name on it at the end to say “thank you.”
There was a softer side to them, but they couldn't show it in the environment they were in. So that really stuck with me-- how does our environment shape how we act? And there’s the act of creating a space where people can show up fully-- where a “tough”guy can say “I crocheted something for you” and he's not going to get beat up for it.
RW: You’re saying they had to keep up this hard front for survival.
Eliza: Yes. Anyway, I remember things like a guy showing me a letter that his child had written to him six years earlier, and that exact moment. His kid was then 11 and he hadn’t seen him in all those years. I mean, I remember the moments when they were sharing their stories with me and I was realizing these men are full, complex humans, more similar than different to everyone else.
RW: Those things can have such depth in them, those little moments.
Eliza: It's funny. I haven't talked about this in so long. [pauses] Yeah, that stuff has stayed with me. [pauses] This is good
stuff! This is deep
RW: This is
deep stuff. How long did you work with these prisoners?
Eliza: It was only four or five months. I had a standing group with ten or twelve men.
RW: Was it your responsibility, and did you have a co-leader?
Eliza: No co-leader. Honestly, I'm surprised that the staff let me do this! [laughs]
RW: Well, that's amazing. I've had some experience with groups and it can be difficult. It demands honesty. Would you agree?
Eliza: Yes, definitely. I mean, they could see right through me. They could tell I was nervous the first day.
RW: So tell me about your own trajectory over those months. What evolved for you in doing this?
Eliza: This is going to seem like I’m not answering your question. So my roommate, when I was living with this woman—she had a couple of spare bedrooms—he was this older guy from Texas. He was blind and he came to learn Spanish. Through our conversations, when he learned I was volunteering at this prison, he was fascinated that I was spending my time doing that. To me I had never questioned it, but he would watch me go out to different prisons and he started thinking, “Hey, I'm here. What can I do?” So he sort of watched my whole trajectory. He wrote me this note that said my actions basically inspired him to ask himself, “What am I doing? And
why am I not also serving?” He still lives in Mexico and has a wife. She's from Mexico and he runs an education organization. I didn't realize at the time the ripples—I was terrified, of course, diving into unknown territories, but I never questioned that because of this stronger desire to support and learn from people. I think that's contagious and it's so cool that my roommate also found his own way of serving. I think it's remarkable what he's done.
RW: It sounds incredible, especially with his being blind. Did you go to other prisons as well?
Eliza: I went to a few before one of them said, “Okay, you can do some work with us.
RW: What was what was the aim of the group?
Eliza: It was a space for honest conversation. That was pretty much the only instruction I was given. They said, “Oh you do psycho-emotional support. Great! These men have no outlet for that.”
RW: Did it ever get intense?
Eliza: Yes. I mean, I was 22 at the time. I was curious enough to jump in, but I also started questioning myself, like what’s my responsibility when I go into a community wanting to serve? What's my role? What isn’t my role? Because I think I was in over my head, and in retrospect, I probably wasn't the best person to be leading that group.
So it made me think a lot about our responsibility when we decide to be of service. Wanting to be of service is a first step, yes, but certainly not enough. We have to also question how our presence affects others, ask about unintentional consequences, and whether one is the best person for the job. There’s a responsibility that comes with being of service that I didn’t fully understand at the time, but that I now take very seriously.
RW: That makes complete sense to me. And it sounds like you learned some things.
Eliza: Yes. I think they were probably more open with me because they knew I was nervous. I’d bring these stupid little activities, like, “Okay guys, we’re going to do art today!”[laughs] These guys are rolling their eyes like, “Okay, Eliza.”
RW: Did they take care of you at all?
Eliza: They definitely looked out for me.
RW: That’s an amazing story. So you were in Mexico for about a year, and then what?
Eliza: I went to grad school for social work at Columbia. I was in New York for two years. That was when I started pushing myself really
RW: What do you mean?
Eliza: I had two jobs. I was working as a social worker in the Bronx. I was also trying to put on these cross-cultural events in my community. I’d written a grant to do some reconciliation work in Guatemala, and I was working a lot on that on the side. I think I got clear about what I was passionate about, but I think I also went into overdrive.
RW: It sounds like you did go into overdrive.
Eliza: Yeah. [laughs] I think that’s when the burnout stuff started creeping up on me.
RW: Well, that must have been kind of a culture shock. But going to Mexico was the first culture shock.
Eliza: Going to New York was harder.
RW: Talk a little about that
Eliza: I mean, I came from a place where community was so important, and connection was so important. Then, I was thrown into this city where you’re just moving all the time, interactions are so fast, everything feels transactional and you’re always trying to get to the next thing. It was exhausting. I was also in social work school in a culture of, “You must keep doing. You must keep sacrificing.” There wasn’t time to have that extra connection with this person, because you had the next person and the next person…
RW: Was the pressure to move fast also coming from the program at Columbia itself?
Eliza: I think it was more outside. I was working in a hospital setting.
RW: This was a practicum connected with your coursework?
Eliza: Yes, with the program. So maybe it was a little bit of both. Like we were short-staffed at the clinic. It was systemic.
RW: What were you doing in the clinic exactly?
Eliza: I was working mostly with young women who needed abortion counseling. They were deciding, do I get an abortion or not? If I do, what’s the process? If not, what are the resources?
RW: Now you got a BA in what, specifically?
RW: Then, after being in Mexico, you went to Columbia University to get a Master’s. And then perhaps a license of some sort?
Eliza: Well my social work degree at Columbia was in administration—Social Enterprise Administration. I was pretty clear at that point. I didn’t necessarily want to just do one-on-one. I wanted to work on systemic issues.
RW: I see. But meanwhile, as part of your coursework, you were actually in a hospital doing counseling?
Eliza: Yes. Because in the first year, you had to get the basics of one-on-one counseling on the way to a Master’s in Social Work. So, I did get trained, which I’m now so grateful for. At the time, I was like, “I don’t want to do this. I want to work on the system. Why are you forcing me to do this?” But, oh, my gosh, those skills have come in handy, no matter what role I ended up in.
RW: Yes. So, I was asking you about the culture shock in New York. You were pushing yourself because of demands from the program and also making additional demands on yourself. And there’s just the pace of being in New York.
Eliza: Yes. It was definitely stressful.
RW: Well, and you got something from your parents. Would you say a little about what you got from each of your parents?
Eliza: I mean, they worked so hard and sacrificed a lot for us.
RW: And you have how many siblings?
Eliza: So, I'm the second of four. I mean my mom started in a trailer home with her sister. They both started selling vacuum cleaners door-to-door. This was in San Diego.
RW: Did they come from another country?
Eliza: They came straight from the Philippines. My dad originally moved to Chicago, and there’s a small Filipino community there and their families knew each other. So that’s how they met.
Eliza: Anyway, so my mom started selling vacuum cleaners, and then went to encyclopedias, then she went into real estate, and now she’s doing really well, she’s excellent at what she does. But she started with a lot of humility and hard work. My dad is like this brilliant software engineer. I never understood what he did, but he was working in Artificial Intelligence for a while. They both started really small and worked really, really, really hard to get to where they are. My mom was always doing these community events as well. Like this is the 19th year that she’s been putting on this neighborhood Easter Egg hunt in Beaverton. There were 300 kids this year and it started with just a few.
It was that combination of really hard work and involvement in the community that I learned from them. The realization that it’s not only about us, it’s about the people around us.
RW: Okay. So, eventually you got through Columbia and got your Master’s.
RW: But you were beginning to get exhausted, I think.
Eliza: Yes. I was actually supposed to stay for three years, and also get a Public Health degree. But I left after two years to go to Rwanda, because I felt like I was losing myself.
I’d come from Mexico; I’d been really involved in the community there. Then I went to New York and totally went into overdrive. And then it was like, I've got to reset. I can’t stay here for another year.
RW: All right. I'm tempted to say this sounds a little crazy to me. Earlier you thought, “I need to take break, I think I'll go to Mexico” Right?
Eliza: That’s true. That’s funny.
RW: And now you decided, “I need a break. I think I’ll go to Rwanda.” How did that work?
Eliza: Right. I joined a fellowship program called Global Health Corps. I applied to it right out of undergrad but didn’t get accepted the first time. I’d remembered it, because I thought, “Someday I'm going to do this program.” It’s kind of like Peace Corps. They send people for a year to work in a community around global health issues. That totally changed my whole trajectory. That was where I met my partner.
RW: Where did you meet him?
Eliza: Our training was at Yale. It was a two-week training before you go to your placement site, and I met him on the first day.
RW: How cool is that? Met at Yale.
Eliza: Yeah, it is kind of crazy. We were pretty quick friends, and then I was in Rwanda. He was in Uganda, so we were like a 20-hour bus ride away. It’s so expensive to call that we were writing letters to each other; he was like my pen pal.
RW: He seems like a great guy. So how long were you in Rwanda?
Eliza: That was a year.
RW: So, tell me about that.
Eliza: So, the person who was supposed to be my boss, quit before I arrived. The executive director of the organization also left, and the person I was supposed to work with, left within two months after I arrived. And they never replaced any of them. So, I was supposed to expand this program.
RW: Wait a minute. You? You were supposed to expand it?
Eliza: Well, with the help of an executive director, a country director and another program manager.
RW: In other words you actually took on some major responsibility with the organization?
Eliza: Yeah. The fellowship is very specific; they put you in what they call a “high-impact” position, a role where your skills are going to help boost that organization.
RW: But then they disappeared?
Eliza: It all fell apart and I ended up having to close the program. I had to fire people who had been there for a long time. That was probably the hardest thing I've ever had to do at work.
RW: That sounds like it would be awful.
Eliza: I mean, It was so stressful. And I wasn’t a part of the community, you know. I was an outsider.
RW: The organization basically falls apart just as you embark.
Eliza: Right. And the person I was supposed to be working closely with quit two months after I got there. She’s from Rwanda and she was supposed to be my anchor.
RW: Oh, my gosh. And the people that you had to fire, were they Rwandans?
Eliza: Yes. It made me question how international NGOs are structured. We were getting instructions from the U.S. to make decisions in Rwanda, for Rwandans. I was so angry at the time. I was like, “It’s not my place to be doing this.”
RW: Of course not. And that’s a huge question. I've heard this critique leveled against other situations where some US organization is “going to help” some other place or country top-down from a distance, not really knowing the culture.
Eliza: Right. So, I learned a lot, but it was hard.
RW: It sounds extremely difficult.
Eliza: And that was when my body started to shut down. I started getting the back pain in my spine and I was struggling with depression. I don’t think I knew it at the time.
RW: Right. Was Joseph helpful to you at all during this?
Eliza: Yes. He bussed 20 hours, at one point, to visit me for a couple of days. Anyway, I was supposed to stay in Rwanda. Then Joseph moved to Kenya and I was supposed to move to Kenya with him. But for once, I was like, “I need to take care of myself before I can keep going.”
RW: So, what did you do?
Eliza: I moved to Boston to finish my degree, but also in order to get medical care.
RW: Your degree? So you have the BA, the MA, and…?
Eliza: And an MPH.
RW: Okay. Where did you get your MPH?
Eliza: At Harvard. So, I did that. That year in Boston was probably the hardest year of my whole life, honestly.
RW: What were some of the hard things?
Eliza: First off, I was undiagnosed for almost nine months. They found out I have this rare thing called ankylosing spondylitis. It’s a genetic disorder, so your immune system attacks your spine. I was seeing specialist after specialist, and they were saying like, “It’s probably an old injury. You did gymnastics. Do some physical therapy.” It got to the point where I couldn’t leave my house for almost two months because I was in such physical pain. I was sleeping maybe an hour at a time. I went down to 82 pounds and the depression kicked into high gear. Then my best friend was diagnosed with leukemia and almost died.
RW: Good heavens.
Eliza: Joseph was in Kenya; his dad passed away while he was there. It was a very difficult time, processing all of this but being 8,000 miles away from each other. Anyways, the irony was I went to Boston to get some self-care and then everything exploded.
RW: That sounds overwhelming. What helped you get through all that?
Eliza: Honestly, what kept me sane was meditation and spiritual practices, because I had nothing else to lean on. I started going to this meditation center. Luckily, it was across the street. I was also reading, like The Anatomy of Hope
by Jerome Groopman, and books about mindfulness and about how hope and resilience manifest in our brain. In terms of looking at health, we don’t pay enough attention to the mental and emotional and spiritual dimensions of it. In the end that was what actually got me through.
RW: So, can you talk a little about the meditation that you started doing?
Eliza: I was stuck in my house a lot, so I was reading different books, like InterSpiritual Meditation.
I mean, I didn’t have a specific practice or a tradition I was following. I kind of formed my own. I was really interested in how the brain works around pain and suffering, and learning that I could pay attention to other parts happening in my mind. So there were a lot of nights where I was just by myself surrounded by a lot of books and a cushion.
RW: When you were on the cushion, you could sit upright? Your spine would allow that?
Eliza: Sort of. I was sitting with pain. I was dealing with that constantly.
RW: Is there anything you can articulate about the healing that began to happen through this new exploration you were doing?
Eliza: I remember one moment specifically—I should mention that I found an organization in Boston called Still Harbor, that I was connected to through Global Health Corps, and they had this spirituality and social justice group at the time that I joined. So, I was learning a lot from them—but I had one specific moment. We were on a two-day retreat at the end of the program, and it was in the middle of the night. I was meditating and something like clicked in my body
. I felt actual gratitude
for all the difficult stuff that had happened. It’s hard to put it into words, but I remember this moment. It was like this is going to help you be compassionate
, and this is going to open your heart to the suffering of others
. This will help you be a more loving human.
It was one moment, but it took me a year to get to that moment. Like I'm like shaking as I'm talking about it. It was only one moment.
RW: I understand what you’re saying. This is where it’s hard to explain what one moment can mean that comes from completely a different level.
RW: Well, that’s fantastic. It re-oriented you or something, right?
Eliza: It’s hard to articulate. I mean, something shifted, but it was a process over time.
RW: And that’s sort of heading right back to this moment here at the table. I appreciate you sharing all this. And you’re still connected with Still Harbor?
RW: What is your role with them now?
Eliza: They’re one of the partners that I consult with, through Circles International. They’re focused on spirituality and social justice. They provide chaplaincy for social justice.
RW: That’s interesting. Chaplains for social justice? Do they represent a particular tradition?
Eliza: No. The executive director is an Interfaith minister, but there’s no specific tradition.
RW: You look like you’re in good health and in good spirits today. .
Eliza: Yes. I think the gifts I was given and internal growth came through programs like Still Harbor, and through these practices I cultivated, also. And the work I do now is very much coming out of a place of joy and abundance, instead of this sense of pushing myself or “not enough” mentality. I think that when I was in overdrive before, it was just because there was so
much suffering I thought: I have to do more
, I have to do more
. And that was never going to sustain me. I had to find something to ground in, something that that could be enough
, that would allow me to do so much more than my former way of thinking and being.
RW: Does Circles International have a place on the ground?
Eliza: We’re based here and there’s another staff member who works in Oakland. There’s another person in Chicago, but we work with organizations all over the world.
RW: How many groups or organizations are you working with?
Eliza: Right now, there’s five.
RW: How did you run across ServiceSpace?
Eliza: Joseph kept mentioning it. He was like, “These are your people, you should meet them.”
RW: That’s really lovely. So you’re consulting with the organizations. You’re not personally going into the prisons and talking directly with prisoners, or going into areas of great trauma that way?
Eliza: I still am, but now I'm working with the staff. I'm working with the people who are doing that work, essentially. One thing I'll say is, I think that the inner work can be so much harder than the outer work and so underrated. But it’s so
RW: What would you say are some of the difficulties of inner work?
Eliza: I mean, you have to confront your own
pain and suffering. And that’s difficult work. But you begin to realize that confronting it is actually much better than avoiding it or working around it. Over time you learn that those places can actually be the same places where joy and service come from, if you’re willing to look at those places.
I learned firsthand how much our inner world affects our outer actions in the world. And how much internal resilience and wellbeing is so necessary to affect change for social justice in the long term. I want to support others in finding their own resilience and passions for service and support them in their path.