This Doctor Treats LAUSD's Newly Arrived Immigrants. She Was Once One Of Them

Claudia Martin, a physician for the L.A. Unified School District, poses for a portrait in an examination room at the district's Student Enrollment Placement and Assessment Center. (Photo by Kyle Stokes/LAist)

One quiet night about 30 years ago, when Claudia Martin was still a child, she was at home in Mexicali watching TV. Out of nowhere, she started to sob.

Her grandmother didn't need to ask why.

"She knew I was crying because I missed my mom."

By then Claudia's mother had been living in the U.S. for about a year. She'd remarried and moved to be with her new husband. Martin was just 6 years old.

Her mother gave her the choice to stay or go. To her, Mexico was home. Going to the U.S. meant starting all over, learning a new language, leaving an identity behind. So she lived with relatives.

That night, though, as Claudia wept, her relatives realized it was time to reunite the child with her mother. Right away, the family started making arrangements to send Claudia to Los Angeles.

Thirty years later, Martin's own experience colors how she digested this summer's news from the U.S.-Mexico border, where the Trump Administration's "zero tolerance" policy separated more than 2,300 migrant children from their parents. More than 100 of these children are now believed to be in L.A.

"That is going to tarnish them for a long time," said Martin.

Martin sees the trauma firsthand every week.

She's now a physician for LAUSD and, one day a week, performs physical exams for young students at the district's School Enrollment Placement and Assessment Center, or "SEPA" Center. Though the SEPA Center does not serve immigrant families exclusively, many immigrant children are referred there because it includes many of the services immigrant children need under one roof: enrollment forms, vaccination, counseling and other care.

Martin's own life story — both as a child immigrant, then as a doctor to immigrant children — reflects lessons L.A. Unified educators and staff have learned from accommodating wave after wave of immigrant children who've come to the district's doors over at least the last two decades.

'THE KIDS AND THE PARENTS ARE EQUALLY SCARED'

Almost all of Martin's immigrant patients enter her exam room on-edge. Some new arrivals have never seen a doctor before and have never heard of a "physical exam."

She sees the questions reflected in the children's faces: What is she doing? the children's faces ask. Why is she touching me? What is going to happen next?

And the parents often seen nervous, too.

"Both the kids and the parents are equally scared, I would say," says Martin, now 36. "They're mistrustful."

LAUSD does not ask the citizenship status of incoming students, so good data is hard to come by.

Over the last five years, more than 12,000 "unaccompanied minors" — children apprehended by immigration agents without their parents — were placed with relatives or sponsors in L.A. County. A good portion of those children presumably wind up enrolling in L.A. Unified schools. Every week, Martin says she sees an immigrant child who's entered the U.S. alone.

The issue of immigrants finding their way in L.A. schools is far from new.

About twenty years ago, L.A. Unified educators raised concerns that immigrant children were having a hard time learning English in part "because of what they experienced in their home country."

That led to the district conducting trauma screenings on Spanish-, Russian-, Korean- and Armenian-speaking students, says Pia Escudero, who oversees L.A. Unified's mental health and counseling services.

The results were stunning. Researchers crunched the numbers and found immigrant children were experiencing trauma at off-the-scale levels. They were so high, Escudero said "our research partner said, go back and do it again, these levels are very high."

That survey found a range of factors causing trauma — all factors still in play with recent immigrant children. Some students experienced violence in their home countries, on their journey to the U.S., or in their new neighborhoods.

Being separated from parents also caused trauma, district officials found. Many immigrant children are coming here to reunite with a biological parent. Others are leaving parents behind.

Either way, Escudero says there's evidence that the separation from the parents can cause developmental delays. "Their brain doesn't develop at the same rate as a healthy child does," she says, which can lead to behavioral problems. It can seem like a child has ADHD.

"We know that children who have these disruptions have a really hard time being calm, being able to adapt to environments," says Escudero. "They're in a fight-or-flight state of being very, very hyper vigilant."

Claudia Martin, a physician for the L.A. Unified School District, poses for a portrait at Plasencia Elementary School, on whose campus the district's School Enrollment Placement and Assessment Center is housed.(Photo by Kyle Stokes/LAist)

'I DON'T WANT THEM TO FEEL JUDGED'

Even before she came to the U.S., Claudia Martin spent a lot of time around doctors and nurses. Her mother was a nurse and would take Claudia to work at the hospital in Mexico on days she couldn't find a babysitter. Martin even remembers sleeping over at the nurses station.

"I literally grew up in the hospital," Martin remembers.

When left Mexico at age 7, she was familiar with getting a shot — which was fortunate. Since she arrived in the U.S. without any immunization records, Martin needed to receive eight shots before she could start the second grade.

It was at the same SEPA center where she works today that she got those shots. Three decades later, she still remembers seeing the mural on the walls of Plasencia Elementary School, on whose campus the SEPA Center was housed. (It's still there today.)

Most of the immigrant patients she sees at the SEPA Center are entirely unfamiliar with institutional medicine and Martin is sensitive to their fears.

With immigrant children, Martin will take it slow. She'll spend two, sometimes three hours examining a single patient. And she needs that time, because she's explaining every step: what a physical exam entails, what insurance is, what pharmacies do...

"When I wasn't able to speak English, I felt judged," Martin says, "so I keep that in the back of my mind — I don't want this family to feel like I'm rushing them because I don't want them to feel judged. It takes a long time."

Still, the patient children are mistrustful, leery. And they do not want to be apart from their parents.

"They want to be with their parent the whole time," Martin says. "They don't want to step away to get their weight checked, to go into another room to get their blood pressure checked."

Why are they so mistrustful? "From experience," Martin says.

"Can you imagine parents talking to their kids: 'We're going up north. We're going to go up to the U.S. It's going to be a better life for all of us. We're all going to be happy.'"

"And soon after you come over, it's completely different. This is not happiness. I didn't envision getting separated from my family, from my parents."

Immigrant children come to Martin's office with a wide range of needs and problems. Patients have divulged to Martin that they have been raped or threatened. Other children come in with previously undiagnosed medical problems — one child arrived showing clear signs of cerebral palsy. Martin's job is to give the children a diagnosis and refer them to a permanent physician.

It's not clear whether any children separated from their parents during this summer's crisis at the U.S.-Mexico border have come through the SEPA Center. L.A. Mayor Eric Garcetti and other local leaders have complained about the lack of information being shared by federal officials with them about the whereabouts and treatment of the separated children.

For Martin, it's hard not to see something of the kids she sees on the news — the children separated from and reuniting with their parents — in the children she treats in her own office.

Martin just hopes they'll all be okay.

"Knowing I'm the first doctor that they've seen in the U.S., that's a big responsibility for me," Martin says, "and I take that seriously. This will impact them for the rest of their life, this interaction, and I want it to be a good, positive one."

"Kids remember the good things," Martin adds. "Hopefully, they'll remember the good things more than the bad things."

Editor's note: A version of this story aired on KPCC. Listen to it here.


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