By Annie Alexandrian

“We must leave evidence. Evidence that we were here, that we existed, that we survived and loved and ached. Evidence of the wholeness we never felt and the immense sense of fullness we gave to each other. Evidence of who we were, who we thought we were, who we never should have been. Evidence for each other that there are other ways to live—past survival; past isolation.”

-Mia Mingus

This piece is dedicated in recognition of the 5-year anniversary of my mother’s passing on January 8th, 2010. I am shocked at how much time has passed, as the shock and unimaginable grief I experienced that day still deeply echoes in my soul and causes pain across my body. Each day that passes may bring me further away from the last day I held you, but everyday I am living in honor of you and Alexis.


As I sit on the BART, I hear the noises of people talking and the train as it moves through the underwater tunnel from San Francisco to the East Bay. The sounds vibrate and join together producing an echo like a prolonged, far away mix of deep weeping and screams similar to my own crying. These sounds while they might be discomforting to others, both comfort and unsettle me. They remind me of the sounds inside a shell that I would put to my ear when younger. My Mom would tell my siblings, cousins and I that the shell captures and holds within it the sounds of the ocean. Amazed at this, I have grown to love the sound of the ocean. The ocean represents many things to me.

Whenever I go back to where I grew up, I am in awe of the ocean and the way the light dances upon it. I often regret not “appreciating” it enough. However, I realize how home to me was not a place, location, but it was people, my family.

No matter where my family lived: in a house in Palmdale, trailer at Cachuma Lake, various motels or in multiple apartments/houses rented throughout Santa Barbara; I have never felt without a home, and for that I feel privileged and grateful. My family has always been my home. The ocean serves as both a place of deep happiness with memories of summer beach trips with laughter and the company of my family, making flutes out of driftwood, and walks along the beach with my siblings to witness colorful sunsets that moved us. The ocean has also been a place of agonizing grief, sun-drenched tears at my mother’s and sister’s funerals, their final resting places, a place of release and goodbyes. A reminder of what my family has endured, both the love and great loss.

The deep sounds of the ocean on the BART train also reminds me of the pain in my mom’s hospital room when I was 19 years old as my cousin Sarah held me as I wept. I called to any higher powers that this cannot be happening and that this was not my mother’s time. After my Mother was removed from life support, I stood across from my older sister Alexis while our mother lay lifeless on the hospital bed between us. As we said our final goodbyes, my sister Alexis and I each unraveled one of my mother’s two braids. I remember the feeling of my mother’s coarse, long, and beautiful black hair in my hands. I told myself to remember that feeling and to not let it be lost. My mother’s hair is similar to mine, and I carry her death and her hopes for my life in my own self. I was in the second quarter of my freshman year of college, and the idea I would drop out was not an option, as graduating from college was a shared dream between my mother and I that she helped me pursue.

My mother lost her life at the age of fifty after suddenly having a heart attack and going into a coma from which she never recovered consciousness. At the time my mother had been hospitalized for a minor pinched nerve in her left leg. The doctors decided to medicate her heavily rather than perform the surgery, which I believe would have been the better option. She was overmedicated to the point where her words slurred and she would go in and out of consciousness. Had my mother been covered by health insurance, she would have had a wider range of treatment options. The sudden death of my mother shocked and forever changed my family. We were still not healed from the wounds of losing Momo (my Grandmother) and my Great-Grandma Eunice, just four years priors. The doctors could not provide a conclusive answer to my family as to why this happened other than that potential causes could be related to her being “obese, having an ‘enlarged heart’, and a history of smoking.” My mother’s heart had been tested before and showed no signs of heart disease. There were numerous times where my mother was treated poorly by hospital staff, for being beyond what they considered a “cooperative patient”, for constantly asking questions, understandably cautious about the information and medication she was being prescribed. Historically, women of color and low-income communities have been marginalized by the medical system and been subject to discrimination.  Various feminist and women of color scholars have examined the intersectional experiences, stigmatization, and policies’ impact on low-income women and/or women of color and their organizing against the medical industrial complex.[1] My Mom faced discrimination and it infuriates me to this day that we could not afford to advocate more to have better answers.

After losing our Mom, my sister Alexis and I both often ached and cried together. And we both felt anger. But my sister’s anger and sadness was something she could not conceal. I tried to contain it all in, tried to stay strong for us both. Because I did not want to lose Alexis too. The relationship between my sister and I struggled after we lost our Mom. The pain was too much, and I was hurt when I felt Alexis was distancing herself from me and my family at times. I knew it was because she did not want us to see her falling apart. But this had hurt and angered me because Alexis, you know I would have tried to pick up the pieces for you and helped you rebuild. My sister, you were like a mother to me as well, and I am sorry if I ever put too much pressure on you to be strong for me, because you were also trying to be strong for yourself. With time my family started to pick up our pieces and rebuild from the loss of our mother, but soon after we would experience another major loss.

In 2012, a short two years after my mother’s death, I was rushed home from a trip with my friends in Arizona due to the deep kindness of loved ones who paid for my flight home, to the devastating news that my beautiful 28-year-old sister had passed away from deep vein thrombosis [which is the formation of a blood clot within a deep vein, in my sister’s case it was in her lung]. My sister had trouble breathing days before this happened, and had planned to see her therapist that morning to see if it was a side-effect associated with her anxiety medication. During this time, over 49 million people including my family lived without health insurance. While that is changing now with the Affordable Care Act, universal health care still does not exist in the United States. Medical coverage and care continues to be stratified by various social factors such as income and documentation status, thereby structuring what type of services and care folks are eligible to receive. As a low-income woman of color without health insurance, my sister was unable to go to the E.R. earlier due to the high costs associated with emergency care. My sister had fallen down that morning at her boyfriend’s house and an ambulance arrived soon after. My father was not allowed to accompany my sister to the hospital and be there with her. The medical staff performed a tracheostomy, which is “a surgical procedure to create an opening through the neck into the trachea (windpipe). A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs.” [2] The procedure was meant to help her breathe, but it was too late and the staff did not know she had a blood clot that was passing from her lung to her heart, leading to my sister’s death.

My sister’s death is still very recent and shocks me every day I wake up and realize I cannot speak with or see her. Why the fuck did this happen is what I ask myself every morning I wake up and when I go to bed at night. I now truly feel the depth of the pain my sister felt. And it is unbearable.  I began to experience constant anxiety and pain in my chest over the next few months of her loss, and a doctor urged me to take several tests after I told him about my sister’s and my mother’s early and unexpected deaths. Tests indicated that I have a hereditary blood-clotting disorder referred to as “Factor V Leiden.” From this I learned that neither my sister nor I should have been taking hormonal contraception that is not progestin-only due to the increased risk of blood clots. My sister did not know this and had recently begun using the nuvaring in the months prior to her death.

I am stunned by the depth of the losses I experienced in the span of only two years. Over the years, I have come to realize my mother and sister’s experiences were intimately informed by multiple structural and social forces such as poverty and discrimination. Being in graduate school for public health I have also learned about toxic stress, and how experiences of intergenerational trauma and injustice become embodied and deeply impact our health. As a multiracial woman of color, historical roots of trauma deeply inform my identity. I think of my Armenian ancestors who are survivors and victims of genocide; my Creole origins that are traced from the island of Martinique to Louisiana, which are a product of rape, colonialism, and slavery. I am reminded of my Japanese ancestry connected to the adversity of being an immigrant and facing forced displacement during World World II through the Japanese internment camps in Los Angeles. As someone who identifies with these various aspects of my racial identity, I cannot claim those experiences as my own. But I do believe the impact of historical trauma, disenfranchisement, and marginalization intersect and have influenced and shaped my family’s lives and deaths, our health, how we grieve, how we cope, and how we move in this world. I cannot help but think about how the various struggles and stressors my family has faced– particularly my mother and sister Alexis–, has also contributed to their lives ending so soon.

Grief surfaces in various ways that must be honored and respected; rather than scrutinized or demeaned. Each of us deals with grief in different and similar ways. I personally have struggled when people have responded to me with statements such as “ I don’t know how you are doing so well?” and express their amazement at my ability to be  “resilient” by staying in school and graduating. I know many of my loved ones who made these comments to me truly care about me and were not trying to be harmful. However, unintentional and maybe sometimes intentional harm takes place when people make assumptions about how one grieves, which only further traumatizes and challenges the healing process. These statements also trivialize and invalidate the way our grieving feels authentically, and further applies pressure on us to perform a hegemonic idea of what grieving should be.  It is incredibly harmful and invasive to expect people to perform a particular presentation of grieving thought to be representative of what grieving should look like. These pressures have made me question myself and stress over the idea that people think I am not grieving and that I have fully moved on, when that is further from the truth. Each day I am reminded of the immense gaps my life now has without my mother Leslie and my sister Alexis. I mourn them each day, especially right before I go to sleep at night and when I wake up each morning. Those moments are the most painful, because I am no longer able to distract myself. The quietness and stillness of those moments are interrupted by a rush of pain that hits me hard without delay and overwhelms me like a fire in my throat to a point where I cannot stop crying and my chest heaves. There have been countless times that my partner will wake up to comfort and hold me as I try to steady my breathing.

A part of my grieving process is being open about how loss has defined and forever changed my life. I will never stop speaking to the impact and importance of how both my mothers’ and sisters’ lives, as well as the circumstances of their deaths, have been central to my purpose in life and formative of who I am today. I speak their names and lives into existence through my every breath. I have come to learn and grapple with the fact that my grieving process is different from how my father or brothers grieve, as well as the rest of my family. In particular, I feel deep regret for scrutinizing my own sister’s grieving process, and now understand more clearly how crucial it is for me and others to be compassionate and understanding about how people grieve. Grief must not be viewed through a negative lens or as a sign that one is unable to heal. I once read on an anonymous post that grief is, “The last act of love we have to give to those we loved. Where there is deep grief, there was great love.” To me, this means grief is an act of resistance and a recognition of how much those we have lost mean to us. Grief can surface both in tears of remembrance, but also in a smile and laughter in reminiscing about moments shared. My grieving process is fueled by a lot of love, but also by a lot of rage, and deep pain at knowing my mother and sister had so many more years and memories to share with our family. I use that deep anger and love to fuel the beating of my heart, my healing, my survival, and my resistance each day against the social forces that have shaped my family’s lives. So, yes while I do find comfort in identifying as being resilient, resilience does not mean one is no longer grieving and that they have moved on. My grieving is my own, and that should be both honored and respected. And so should yours.

To my mother Leslie and sister Alexis,

Each day, in the corner of my eye, I search long and deeply for you both. I can sense your presence and I speak with you everyday. Remembrance of times we had so vividly set my heart afire. I reach for these memories each day, squeezing them in the palm of my hand, never letting them go. Hoping to stay within moments already long past, but within seconds I’m shaken back into the present, to a place without you both. I know you are here and that you are carrying me as I move through this world without you both. I especially want to thank you for ensuring that my place in Berkeley is not far from the ocean and is just a short bike-ride to the marina.  I deeply treasure the picture that captured all three of us on the rocks of Faria Beach in Ventura. On a home a video of that moment, I remember I had said something like “My heart feels beautiful”. Those words still resonate and ring true many years later and truly capture how I feel when I am near the ocean or when I hear sounds like the ocean and feel that deep love. A beautiful reminder of what was, what remains, and why I must continue on.

[1] Roberts, 1999; Davis, 2008; Solinger, 2013; May, 2010; Rousseau, 2009; Ehrenreich & English, 2005; Silliman, Fried, Briggs, 2002; Ross, Gutierrez, 2004; Nelson, 2003; Gutierrez, 2008



Annie is a compassionate, generous, and radiant spirit. She is a resilient multi-racial womyn of color, of Armenian, Creole, and Japanese descent. Annie is invested in creating spaces within which women and femme folks can exhale and breathe in ways that are affirming to us and reflect on our intrinsic sacredness. She is continually healing from the unimaginable grief and the losses of her Mother and sister Alexis. Defined by their absence, she attempts to fill the gaps with her future and a drive to address the structural and social conditions that allowed for such losses to occur. She carries their spirits and words through moments of silence and laughter. They are and always will be what fuels her activism, her education, and why she is able to wake each day and brave this world in which they are no longer physically here.She is personally and academically passionate about intersectionality and the social determinants of health, community-based work, the impact of toxic stress and trauma on intergenerational health, and equitable access to quality reproductive health and postpartum services in low-income communities of color. She loves writing poetry and fiction, going to spoken word performances and concerts, watching horror movies, and biking to the Berkeley Marina. Annie is intentional with her words and the relationships she cultivates.  As a graduate student, Annie seeks to decolonize and challenge the hegemonic ideas and frameworks within the field of public health. Annie is a womanist, full-spectrum doula-in-training, and a writer. Living each day in remembrance of her roots. Working in search of justice and love. She is one of the Co-Founders of This Bridge Called Our Health.

Photo: Courtesy of Annie Alexandrian