“Do you need some practice giving the skin test?”
“That might be helpful,” I replied in a low voice.
She gave me a knowing look and went off to fetch a TB syringe and some saline. “Right now?” I asked.
“Sure, right now. No time like the present.” She grinned at me. “You’re the guinea pig. Hold out your arm, and watch how I do it. Then it will be your turn.” Her voice took on a warm, educational tone. “It has to be on the forearm,” she said as she filled the syringe with saline, “and the needle has to be inserted at a ten- to fifteen-degree angle. It should be shallow enough for you to see the needle under the skin. Like this.” She wiped my arm with a swab and delicately inserted the needle under my skin. I watched. “If you go too deep, it won’t work. If you do it right, you get a bubble called a bleb. If there is no bubble, you need to try again. The angle has to be exact.” Sure enough, a little bubble had popped out on my skin. “Now it’s your turn. You can do yourself.”
An hour later my forearm looked like a sieve. I was proud to note where I had made the skin bubble, showing I had done the test successfully. And I never again forgot to give a tuberculosis test.
“Juan is back,” Michelle said, her hands full up front. “Can you get him?”
Juan was a slender Mexican boy with smooth golden skin, shiny black hair, and intense almond-shaped eyes. He had grown up traveling the migrant farmworker route with his family, living in a series of trailers and shacks on farms across the country, often in foul conditions. As a child he didn’t go to school. He labored in the fields despite laws that are supposed to protect children from such abuses. Eventually times got tough, and he wound up on the streets. “My mom, she got the cancer,” he had told me. “My dad, he worked, but he couldn’t make enough to feed us all. I was the oldest, so I left. I was sixteen.”
Juan was now eighteen. He was a hard worker, but finding a job as an illiterate Mexican was not easy. I asked him how the search for work was going.
“I got a job house painting,” he said in Spanish.
“Muy bueno,” I said, wishing my Spanish were stronger. I could speak the language well enough from my Mexican mother, but I lacked nuance. And unfortunately, medical terminology often escaped me. My parents had decided not to teach us Spanish when Stephanie and I were little. It was in the days before we knew that learning two languages had many developmental advantages for a young child. At the time parents were actively discouraged from teaching more than one language. My own parents worried I would just be confused and do poorly in school. But because I didn’t learn Spanish until I was older, I was not as fluent as I could have been.
“But that job ended,” Juan continued in Spanish. “The economy, it is hard to find any work.”
“Where are you sleeping?” I asked.
“In this old house. No one lives there. It is cold at night.”
“Juan, how come you don’t stay at one of the adult shelters? You’re eighteen. You could stay at one of the shelters downtown.”
“Dr. Christensen, those are bad places.”
“What do you mean?”
His dark eyes were grave. “Bad things happen there at night.”
“What kinds of things?” I asked, curious. He was the second young person to tell me that some of the adult shelters were bad.
“Bad things, period.” I could tell he didn’t want to tell me more.
“How are your meds?” I asked. Juan handed me an empty bottle. He had been born with a seizure disorder but never had insurance to pay for his phenytoin. I worried. He could easily die from a seizure. “Have you been having seizures?” I asked.
He nodded, looking as if he were somehow at fault. “Even with that medicine,” he said.
I checked his charts. Juan hadn’t been evaluated in years. His dosage probably needed to be adjusted. That was not something I could do. He needed to be seen by a neurologist. Once again I felt slammed against the wall of access to health care. Juan didn’t have identification, and without identification he could never get state insurance and a referral for a neurologist.
“Juan, I’m going to make a call for you, OK?”
I stepped outside the exam room to the front of the van. Michelle was doing an intake with a heavyset girl with short dark hair. The girl had the frightened look of the newly homeless, her eyes huge in her face.
“Dr. Hendin?” I said on my cell. “I have a favor to ask.”
Dr. Barry Hendin was a respected neurologist in the community. He was also my sister’s doctor. Setting Stephanie up with him after her diagnosis was probably the best thing I had done to deal with the disease that had taken my sister from being an active mom to being a woman who couldn’t get up a four-inch curb without help. Dr. Hendin was a warm, Marcus Welby–style doctor who exuded caring and confidence. He was a healer.
“The problem is he doesn’t have any insurance,” I told Dr. Hendin after apologizing for taking up his time. “Our program can help out with costs, I think. He desperately needs an evaluation.”
He interrupted good-naturedly. “Don’t worry. I’ll have my receptionist schedule him next week.”
I felt a surge of gratitude. A lot of people wanted to help homeless kids; they often just weren’t asked. “Thanks. I’ll let you go. I know you’re busy.”
“It’s fine. How’s your sister? I haven’t seen her for a bit.”
“She just got back from Mexico. She was feeling good enough to take our mother. I haven’t seen Stephanie so happy in a long time.”
“Did she take those boys of hers?”
“Yes, and my mom had the time of her life with them. She had wanted to go to Mexico for ages.”
“And your sister’s husband? Curtis, right?”
“He went too.” Curtis had been a rock for Stephanie. He was always there for her and endlessly patient with her MS.
I thanked Dr. Hendin and told him I’d make an appointment for Juan.
A few weeks later Juan dropped by the van. It was early December but as warm as always in Phoenix. Dr. Hendin had evaluated him and adjusted his meds appropriately. His seizures were back under control. Even better, he had found work. “It is roofing. It will be hot under the sun. But I’m used to that.” The dark muscles of his shoulders were a stark contrast to his white tank top. I noticed the tank was white and clean. His clothes looked freshly laundered.
“Did you find a place to live, Juan?”
“One of the guys on the crew, he asked me to stay at his place. He’s a good buddy. Now that I make a little, I can help with rent.” He gave a shier smile. “I met this nice girl too. Her family is from the same part of Michoacán as my family. Her name is Gabriella. She’s going to school and is teaching me English.” I could picture Juan as a husband and father, a good provider, and a contributing member of society.
I congratulated him in Spanish. “It sounds like your life is looking up.”
“No kidding. I still don’t have insurance,” he said apologetically, handing me another empty bottle.
“One step at a time,” I said, examining the dosage that Dr. Hendin had written.
When I saw the pastor leading Donald up to the van, I thought, Now he’s going to ask us to find him a shelter bed. So far the efforts to get Donald identification had been fruitless, so he still couldn’t qualify for any evaluations or services. Without identification he couldn’t even get food stamps. His delays were more apparent over time; he was taking remedial classes at HomeBase but struggled with reading. As charming as Donald could be, I was sure there were times he was frustrated. I wouldn’t have blamed Pastor Richardson if he had come to a time when he decided he no longer could care for this large, brain-damaged boy.
But to my delight that wasn’t the case. Pastor Richardson spoke. “We dropped by to tell you that the HomeBase shelter is having a little Christmas dinner. Going to be tomorrow, if you can make it.”
“Can you come?” Donald was excited.
“Sure. Amy and I wil
l be there,” I said.
The next day, at HomeBase, the folding tables were laden with serving dishes, a hodgepodge from turkey to casserole. Each table had a homemade gingerbread house as a centerpiece. “Don’t eat those,” Wendy whispered to me, laughing. “We ran out of frosting and had to use caulking to glue the sides together.”
The kids finished carrying out the food, teasing one another with good nature, hailing one another in fake waiter accents, unfurling paper napkins as if they were fancy cloth ones instead. Amy and I volunteered to dish out food. When everyone was served, we filled our own plates. The meal began with a brief prayer, and I bowed my head for my own thanks. It was crowded inside, so we went out onto the porch. Pastor Richardson came out with his wife and introduced us. She was a short lady wearing what appeared to be a wig. She had dressed as if for church, with heavy hose and sensible shoes, and when she sat near me, I smelled a perfume that made me think of grandmothers’ houses and laundry hanging over the line. It was comforting. The night was pleasant, the air just slightly cool. Stars showed in the sky, and the lights of the city caught the tops of nearby palm trees. The warm winter weather in Phoenix was lovely. There was a distant hum of cars.
“Are you still bringing Donald here?” I asked Pastor Richardson.
He nodded, his mouth full.
“Good place.” He cut his food. “He’s been getting all sorts of help. Counseling, job training, classes. He wants to get his high school diploma.”
“That’s wonderful,” I said.
He chuckled. “He’s got some catching up to do.”
“A whole lot of catching up,” his wife added.
“Might take some time, and they said it would be what they call a modified diploma nowadays, you know, for slower folk.”
“Nothing wrong with that,” his wife murmured.
They told me how they had two kids of their own, a son, who had gone to Hampton University, and a daughter, who had gone to the University of Washington, clear up in rainy Seattle. The son had a master’s in social work, and the daughter taught theater, but her real passion was art, and wasn’t the world a funny place? Pastor Richardson’s wife revealed that they’d raised other kids, most of them the children of relatives, but some not related at all. Amy asked how many, and she had to turn to her husband.
“Eight, I believe,” he said, chewing and swallowing.
“That’s not counting the ones who stayed just a bit,” she said.
Kids kept coming out on the porch to talk. Matthew, the skinny blond boy, asked after Jan the way he always did. Donald joined us, stretching his legs down the steps. He was wearing new blue work pants and a heavy shirt. His hair was a little longer, covering the scars. I noticed that out of his dirty overalls and with his hair growing out, he was a handsome young man. He bent his head over his plate and said grace. “This is good,” he said, and quickly cleaned his plate.
A girl came and sat down on the steps below him. She stared at Donald. She had dark brown hair parted in the middle and round brown eyes. She tucked her hands under her legs.
“Donald?” she asked. “Want to go play pool?”
“Sure.” He got up. “But let’s have some pie first.”
I heard him tread heavily inside. The girl happily followed.
“How long do you think he’ll be at your place?” I asked Pastor Richardson.
His wife looked alarmed. “What do you mean?” she asked.
“We don’t want to get rid of him,” Pastor Richardson said quickly, as if I were going to steal Donald away. I felt a moment’s pang. This couple was treating Donald like a prized, desired child. If only the other adults in his life had treated him the same way.
“Having him around is nice,” his wife said. “And you know he loves to play basketball with his cousins?”
His cousins? I thought happily. Now they are giving him a family.
“I figure God brought him into our lives for a purpose,” Pastor Richardson said. “He left that boy sitting outside our church for a reason.”
“Amen,” I heard his wife say.
I was wondering about Donald’s future. He was a young man now. I didn’t know what the Richardsons were planning for him. How long would they be a resource for him? “Are you planning on keeping him for a time then?” I asked hopefully.
“I don’t see why not,” the pastor said. He stood up, shaking his pants out. “Now, I think Donald had the right idea. Who wants pie?”
After the party was over, Amy and I helped wash up. Amy was wiping down the tables and I was putting away dishes when the pastor and his wife left with Donald. The boy towered over both of them.
“That Pastor Richardson,” Wendy said, watching them leave, “ever since he heard about us, he’s been helping out around here all the time. He even had his church in to paint the kids’ rooms.”
Amy folded the washcloth. “He didn’t tell us that. That’s wonderful.”
I felt a wave of appreciation for the shelter and all the amazing volunteers who dedicated their time to understanding these kids. I suddenly thought about what Juan and Sugar had said about the adult shelter downtown. I had assumed that all shelters were as supportive and safe as HomeBase. Maybe that wasn’t the case.
“What do you know about some of the adult shelters around here?” I asked Wendy. “Like the one downtown.”
Wendy grimaced. “I know that one in four adult men in Phoenix area shelters are registered sex offenders. That should tell you enough.” She wrapped a leftover wedge of pecan pie in foil and added it to her stack of leftovers. “I’ve heard horror stories from some of the older teenagers. Some have been raped. Boys as well as girls.” That was what Sugar was talking about, I thought. I realized why she and many of the older teenagers avoided the adult shelters. But there were so few beds that opened up in a place like HomeBase.
Matthew caught up to us on our way to the truck. His blond hair glowed in the moonlight, and the light wind billowed his white T-shirt. “Dr. Randy,” he called, trotting up. He handed me several foil-wrapped packages. “We got some extra pie for you.” I expected Amy to tease me about this, because she knew how much I liked pie. Instead she just captured my hand and held it all the way home.
6
THE HEART OF DIXIE
It was early spring before the staff at HomeBase was able to get Donald identification. His father in Alabama had been no help. He refused to answer phone calls or letters. Jan told me all about it as we stocked the van one evening, loading medications and checking them off our lists. “Finally they tracked down a birth certificate from a county hospital in Alabama,” she said. “If Pastor Richardson hadn’t taken him in, who knows what would have happened to that boy.”
With the identification we were finally able, with effort, to get Donald on the state insurance. As soon as he was approved, I set up appointments for neurological tests for him at the hospital. It was time to get to the bottom of his delays. If Donald suffered from any sort of deteriorating condition or needed treatment, I wanted to know.
I helped him check in one evening at the hospital. He waited on the edge of his hospital bed, looking large and helpless in his blue gown. Mrs. Richardson had given him an old flowered suitcase for his few belongings. I was touched. I had seen kids admitted into a hospital with little more than a paper grocery sack to hold their clothes.
“You’re going to be OK,” I tried to reassure him.
He looked as if he were going to cry. I could see the scars on his scalp through the bright lights where his hair parted. “I want the pastor,” he murmured.
“He had to go to work. He’s coming back once your tests are done.”
“Ain’t going to take no bus,” he whispered.
“What bus?” I asked. Donald didn’t reply. It took me a moment. Donald was afraid I was going to put him on a bus the way his father had. I realized that Pastor Richardson’s leaving him at the hospital had triggered fear in Donald. He had been abandoned before, and he thought he wa
s being abandoned again.
“Pastor Richardson is coming soon.”
“No bus.” He looked as if he were ready to run. His muscles tensed. I could see the panic rising in his eyes. “No bus!”
“Donald, would you like me to stay?”
His eyes slid toward mine. “OK.”
“Let me make a call.”
“No bus.”
“No bus. I’ll be right back.” I stepped out the door to call Amy and tell her I would be late.
I waited with Donald for an hour until Pastor Richardson arrived from work. He would help Donald until the tests were done. He was dusty and shrunken-looking and tired from his drywall business. It wasn’t until I was driving home that evening that I remembered I had promised Amy before that I would come home early. She had something to tell me. I wondered what it was.
When I walked in, I could smell freshly baked cookies. Amy was in the bathroom, brushing her teeth. There on the counter was an early pregnancy test.
I felt delight bloom in my heart. “When?”
“We’ll see. I’m guessing November.”
The specialist called us in the next day. Donald had been given an MRI as well as other tests. I met Pastor Richardson and his wife outside Donald’s room. The specialist began talking the way neurologists do, about tests and skills and frontal lobes and executive functions. I could see the pastor was not following anything. I barely understood it all myself.
“Can you cut it down for us?” I asked.
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