“No. It’s the nicest thing you’ve ever done. OK, except for Janie and Reed.”
The drive to Mesa took longer than I had hoped. “This is our busiest yet,” I told Wendy. Dozens of kids were waiting to be seen soon after we pulled up in front of the shelter. There was a line out the door and more waiting in groups. Even the Mesa police were bringing them in. An eighteen-year-old Navajo girl brought her baby sister for medical care, carrying her in a sling around her waist. “My name is Rebecca,” she said softly, “but my Navajo name is Nizhoni.”
“What does that mean?” I asked gently.
She laughed shyly. “Some say ‘beautiful one,’ some just say ‘beautiful.’ ”
I noted that her long black hair was clean. She had the smooth, regular features of a Navajo, with golden skin and dark eyes. She was dressed in jeans and a clean top. She wore small turquoise studs in her ears. The baby’s sling was freshly washed, and the little feet poking out were covered in clean socks. Nizhoni was evasive when I asked her where their parents lived.
I took the baby gently from the sling. I studied her for a moment. “Did you know your sister is albino?” I asked quietly. The condition led to a complete lack of pigmentation. The baby looked up at me dreamily. Her pale eyes were like the reflection of a light blue stream. She had white lashes and, though she had the same strong Navajo features as her big sister, white hair and white skin. She was less than a year old, and she kicked her fat little legs as I examined her. Albinism in infants can be very dangerous; the pigment serves a protective purpose.
“The doctor told my parents that she was an albino when she was born.”
“Where are your mom and dad?” I asked. Nizhoni didn’t answer, looking at her fingers. It crossed my mind that she might be the mom. Maybe there was a reason she was denying it “Are you the only one taking care of her?”
Again she made a murmuring answer, half yes, half no. I suspected they had a home of sorts. But I wondered why she was playing mother to a little baby. She wasn’t equipped to take care of a medical condition like albinism.
“Does she have protective eye wear?” I asked. She shook her head, confused. I explained that if the baby didn’t wear protective glasses, her eyes would let in too much light and she would go blind.
“My mom and dad—” She started to answer and then stopped.
“What?”
She didn’t answer. Something in the way she picked up the baby, with long practice, gave me answer enough. For whatever reason—maybe her parents had alcoholism, AIDS, cancer—this teenage girl was the only mother this baby had ever had. I gave her everything I could and set her up with appointments for a specialist for her sister. I weighed the baby and gave her a good exam. Nizhoni left with her sister cooing in her sling. After she was gone, I realized I had spent all my time on the baby sister. The big sister needed our help just as much, maybe more. I had foolishly ignored her.
It was more than a month later that we were back in Mesa and saw Nizhoni again. Looking distraught, she came in carrying her little sister in the sling.
“My parents,” she whispered. “They took the baby in the sun. I was at school, I couldn’t stop them.” The baby swung silently. I lifted her out of the sling and held her up to my face under the exam room lights. She looked back with pale eyes.
“It’s extremely important we get her to the ophthalmologist immediately,” I told Nizhoni. “The exposure is already causing permanent damage. If it keeps happening, your sister will go blind.” I set up the appointment for her, gave her explicit directions and bus passes, but when I called the center later, it said Nizhoni had never arrived.
Another month passed. Jan and I were told that our trips to Mesa had to be canceled because the local shelter was closing. There would be no safe place to park. Hoping to see Nizhoni, I took the van out one last time. I couldn’t find her, and no one I asked seemed to have heard of her. I wanted to think she had gotten help. I kept seeing the baby’s pale eyes, under my lights. Another one lost, I thought. If only I had had more time. Regret filled me. I wished I had driven her myself to the appointment. I wished I could find her and continue to see her and help her and her sister. I reminded myself of the old saying: You can only affect the future. But I still ached.
This was the hardest part, I thought. There were going to be times I couldn’t help everyone. I knew if I dwelled on these losses, I could become incapable of helping the next child. At least that is what I told myself. And then something would trigger the memory of the two of them, and I would see Nizhoni in my mind, standing next to me as I lifted her sister to the lights, and in my fears the baby was looking through me with forever sightless eyes.
Several of the local residency programs wanted to send their residents to us. The experience on the van would broaden their experience as well as give them some valuable medical education. Many times the programs would send a resident for just a day or two, to give him or her a taste of real-life medicine.
This day the resident was a young, gawky-looking doctor with unfortunate jug ears. The kids reacted to him with suspicion. I soon learned why. He was sitting in the lawn chairs, cussing up a storm, and trying to sound streetwise. “Dude, I know just what you’re talking about,” he told one kid, along with a string of colorful cusswords.
I immediately called him over. “Listen, that’s unprofessional behavior.”
“What is?”
“Swearing.”
“Oh, I was just trying to build rapport,” he said.
“We’re running a mobile hospital, not a locker room,” I said. “If Jan had heard you, trust me, you would feel the hurt.”
“Yeah? That nurse? Well, the kids need someone to relate to them,” he said smugly.
My frustration was building. It had been a long, hot, sweaty day, and sometimes I felt that with the developing recession, the needs of the kids got worse and worse. More and more kids seemed to be on the streets because their families had been destroyed by unemployment and poverty. “That nurse is a hundred times more popular with the kids than either of us will ever be, believe me. You know why? It’s because she’s not afraid to be an adult. These kids don’t want children pretending to be cool. They can get that a hundred times a day on the street. They want adults they can trust.”
I softened my voice and asked him a question. “What’s your background?”
“My background? I was at Harvard. Top of my class.”
“Harvard. Were you a homeless kid?”
“You’ve got to be kidding.” He laughed.
“Then you don’t need to pretend you are.”
He looked disbelieving. “They need rapport,” he replied, looking at me as if I were unbelievably dense.
I now felt I was cradling my temper with both hands. “Rapport doesn’t happen because you are trying to be cool. Trust me on that. I am so not cool.” I had learned that from Jan, I reflected. The best way to develop a connection was to be a positive authority figure.
Jan had walked up behind me. “That’s right,” she said with a smile. “You are so not cool.”
I stomped off and went back in the van. I was upset. How we presented ourselves to the kids was vitally important, and unprofessional help tarnished our image, not to mention impeded our ability to help the kids. If there is one thing that is not romantic, I told our volunteers, it’s the life of a homeless child. There was nothing cool about being homeless. I began pacing the van. Jan called me for another patient.
“You take this last patient,” she said soothingly, knowing I needed to cool off. “I’ll shut down the van with Mr. Rapport.” She pointed a thumb at the intern, who was now standing alone at the edge of the van. The homeless kids had shut him out. Maybe, in the long run, I thought, this would be a learning experience.
I dashed into the office the next morning, my stethoscope flying. I had been up much of the night, helping Amy feed two cranky babies.
“Randy, we’re in trouble.” Jan met me immediately at t
he door. “The Flinn Foundation just changed their mission.”
“Oh, no.” The Flinn Foundation had generously funded our first few years. The foundation was a wonderful nonprofit organization. Like most nonprofits, it had a mission statement about what it wanted to support. Before, its mission statement had been to improve health care in Arizona. We had applied for grants, and it had been extremely generous. Now Jan told me the foundation was moving into supporting programs that enhanced biosciences. Obviously the van had nothing to do with the biosciences. Changing its mission meant a huge source of our budget had just vanished. “We’re in crisis,” Jan said.
“How long until we run out of money?” I asked her.
She hedged. “Soon enough. The medications alone are a huge bill. Our overhead is a monster, with everything from gas to gowns. You know how it is,” she said, pointing at the stained and buckling ceiling above us. “We’re always living on the edge. But now this—we can’t make it long.”
“What do you think is the answer?” I asked.
She thought carefully. “My opinion is we are relying too much on a few big donors. As great as they are, they’re hard to find. What will really keep us afloat are the smaller donors and the smaller grants. They’re the ones that add up.”
“How do we get those?”
She smiled and poked me in the chest. “You’re the boss.”
When I had a brief break from the van that day, I called Dr. Irwin Redlener, who had founded the Children’s Health Fund, along with Paul Simon. I felt a bit bowled over by him. He was such an animated person, so passionate, so confident.
“Randy, this is your element,” he said right away after I had told him our predicament. His rough voice was reassuring. “It is up to you to tell the story of these kids.”
“And funding?”
“That’s what I was just talking about. You need to get out there and tell the stories of these kids.”
I didn’t think I would be a good public speaker. I was worried about my stutter. It always got worse onstage. I told Irwin, but he didn’t care. He gently pushed back. “You can do it,” he said. “People won’t care if you are polished. Matter of fact, they’d rather you not be. Just tell the story from your heart. When you’re talking to me, I can hear in your voice how much you care. No one is going to help if you don’t ask for help.”
I thought about it over the next few days, which were as hectic as ever. My experiences with the Old Timers had been so positive, even if I felt I had goofed my speech, but I still wasn’t sure I could do a big event. Still, I saw I needed to give it a try—I wasn’t about to let the van fail because I was stage shy. So I made some calls.
My first fund-raising event was at a Lions Club annual dinner. I had picked the Lions because their mission, which was to help people with disabilities, encouraged me. Their annual dinner was being held at a McCormick & Schmick’s seafood restaurant, and while the food looked and smelled delicious, I was too nervous to eat my Dover sole. I took the small stage and looked over the faces, turned up to me. Many of the members were elderly; quite a few were blue collar, and most were wearing their well-washed best, the men in bow ties and the ladies in flowing dresses, and there were more than a few military medals and pins thrown in. As always it amazed me how people from different walks of life spent so much time trying to help others. Few of these people probably had a reason to care about homeless kids. Yet they did.
I talked about some of the kids I had seen, taking care not to violate their confidentiality. The further I got into their stories, the more my voice choked up. I felt rather than heard the silence in the room. Finally there was applause. My shirt was soaked under my jacket, and when I opened my eyes, I saw everyone was standing. They were standing for the kids.
Afterward a man came up to me with a check for two thousand dollars. I guessed from looking at him that this was money he had worked hard for, and tears of gratitude filled my eyes.
8
ROULETTE
Go see who’s in the exam room,” Jan said. Sugar. It had been many months since I had seen her. She was sitting on the table, her hands between her legs. Her curly hair was long. It hung limply by her cheeks. Her face was down, pointing at her knees, which were clad in scuffed, torn jeans. I felt a surge of relief just that she was alive.
“I can’t stomach calling you Sugar,” I said, going in. “I think it is time you told me your real name.”
She turned her face up. She had been badly beaten. Her jaw-line was purple and swollen. Her lips were bruised and split. Her left eye was a purple mass. I felt myself gasp. “What happened?” I asked, my voice calm, despite my horror. “Who did this to you?”
She spoke through bruised lips. “John.” She said the word in a monotone. It took me a moment. His name wasn’t John. He was a customer.
“Someone you know? A regular?”
She shook her head. She trembled a little and pressed her legs together. I suspected then that it had been more than a beating. “It was a white guy in a van.” She gave a desperate little cough.
“Were you raped?”
She nodded, and the tears spilled. She tried to wipe them away. “Stupid.”
“You’re not stupid. You’re hurt,” I said, passing her a Kleenex. She wiped her face. When she leaned over, I picked up the stale, rank smell of fear, the kind of sweat that comes only when people are in terror.
“We’ll need to examine you. Would you rather have Jan?”
She nodded. The tears were flowing now. Her shoulders began to shake.
“Good, that’s good. I’m glad you’re thinking of yourself. When Jan’s done, I’m going to look at your other injuries, OK? But only after you’re dressed.”
She nodded. I had never seen Sugar cry, and something about it was more heartrending than anything I had experienced with her before. This incredibly strong girl, I thought, this strong girl.
A few minutes later, after Jan had examined her and taken some cultures, we talked in private. Jan’s face was sad but calm. I was suddenly so glad to have Jan here on this particular day, with all her experience and wisdom.
“There was vaginal and rectal tearing. It was a violent rape. He hurt her. He was trying to hurt her. But she refuses to let us call the police.”
“Why?”
“She says they won’t believe her.”
The idea was appalling. “Do you think that’s true?”
“She said they’d say there is no such thing as raping a prostitute.”
“But she didn’t ask to be a prostitute.”
“Maybe that’s not how they would see it. I don’t know. That’s not how she sees it. This is a girl with extremely low self-esteem,” Jan said. “Whatever happens to her she thinks she deserves it. Plus, she’s eighteen. We have to respect her choice.”
“Amy said something like that once too,” I said.
“Well, maybe it’s time you listened,” Jan said. Her smile wobbled a little around the edges. I could tell the exam had gotten to her. I thanked her and went back to the exam room.
I wished there were a way Sugar could be taught to love herself. I wished there were a way she could see that she deserved better. Jan had given her a box of apple juice. She was carefully sipping from the straw. I put on fresh gloves and began checking her facial injuries. There were a lot of small cuts.
“Was he wearing a ring?” I asked, looking at the inside of her mouth.
“Wedding ring,” she mumbled.
“Your teeth look OK. No eye damage.” I finished the exam. “It should all heal.” At least the outside, I thought.
“I should have known better,” she whispered. “A white guy in a van.”
“Don’t blame yourself. Blame him.”
“Stupid.”
“If you report this to the police, you can save another girl from going through the same thing.” I felt as if everything I was saying were falling on deaf ears.
“It’s all the same.”
“It�
�s not,” I said.
I saw her becoming resistant and defensive. I was not going to badger her, especially not now.
“I’m going to give you a shot of Rocephin, a dose of Zithromax, and a dose of metronidazole,” I told her. “Those are in case you were exposed to anything. We’ll be testing for hepatitis, HIV, syphilis, chlamydia, and gonorrhea. I’m going to assume there was no condom.”
She wiped a stray tear. “No.”
After she had left, I went and sat down up front. I rubbed my face with my hands, smelling the powder smell the gloves had left. Jan came and joined me. I was glad there were no other patients for the moment. “Of all the days for you to be here, Jan, well, I’m glad,” I said.
“I’ve been nursing for a long time,” Jan said after a long pause. “I’ve seen a lot of rapes.”
I looked at my hands. “I feel like I’m going to dream about bruises. Why won’t she see a counselor?”
“You have to give it time,” Jan said softly.
“What do you mean?”
Her eyes were distant. “Sometimes it takes a few months. Then the symptoms start: the nightmares, the flashbacks, and the insomnia. That’s when she might be ready for help.”
“I’m not sure I understand.”
“Understanding rape is part of our job, Randy. Please try to recognize why a woman would want to try to forget it.”
“OK.”
“This is hard work, Randy. Make sure you take care of yourself.” She paused. “Let other people take care of you too.”
I knew Jan was right. More than two years had passed since we started the van, and I had spent all my time trying to help others all by myself. I left out my own wife far too often, and in trying to do everything maybe I wasn’t doing it right at all. But it was easier to recognize this than to change it.
At home that night I took Ginger for a long walk. Soon we had covered over two miles. I was cutting through an extremely wealthy neighborhood where houses were hidden behind high walls. The sun was setting. I thought about how some people might feel frustration with Sugar. Why wouldn’t she go to the cops? they would ask. I didn’t feel that frustration. Instead I felt a huge burden. Here was a child who had been neglected her whole life, raped into prostitution, and then left to make decisions all by herself. Of course they were not the right decisions. But they were her decisions. I had to support them.
Ask Me Why I Hurt Page 15