“The wedding was in Pastor Richardson’s church,” I said.
“Of course,” he said.
I felt a trembling of emotion that threatened to break through me. It all came crashing in: the van, the kids, the schedule, the worries, Nicole and her pet of hair, Amy and my ongoing struggles to let her be my support, my own children and my guilt at not being the father I’d always wanted to be. And now here was Donald, smiling at me more brightly than any stained glass window. There was a reason for it all, I realized. Good things could happen. I lifted my head and looked into the clear blue sky. It was as if I could see right through it into the heavens.
11
UMOM
The girl was pregnant. She was pretty far along, at least six months. Her belly was distended, and her ankles were so swollen they lapped over the tops of her sneakers. She was seventeen. She wore dirty gray socks with tiny pink pom-poms. I examined her carefully. She had all the complications of a homeless pregnancy. Her throat was swollen. Her tonsils were infected. Her gums were radiant with gingivitis, which was particularly worrisome because oral decay can send a cocktail of bacteria into the bloodstream toward the developing baby. She had signs of anemia and low calcium. She, and her baby, had received no vitamins, no tests, and no prenatal care.
“What sort of foods have you been eating?” I asked.
“I’ve been drinking milk,” she said defensively.
“We buy the white kind, not just chocolate,” the boy standing next to her said. “When we panhandle enough, I buy her a whole quart.” She had insisted the boy join her for the exam. He was only fifteen. He had lank brown hair and sleepy green eyes. Cat’s eyes, I thought.
“Are you the father?” I asked.
He looked at her for help. The two exchanged a glance. “I was gang-raped,” she told me. “It was a bunch of guys. I was sleeping in the park. I woke up, and they were on top of me. I don’t want to talk about it.”
“Would you like counseling? I could refer you—”
“No,” she said.
“When you’re ready,” I told her, “I can get you help. OK?”
“I’m going to be the dad,” the boy said. He covered her hand with his. “I’m going to take care of her and the baby.”
I looked at them. He was fifteen and homeless. She was seventeen. She was also homeless. “Raising a baby is hard,” I replied.
“It’s my baby,” she said stubbornly. “I don’t care if I got it because of rape.”
“Me either,” said the boy.
“I’m not an OB,” I told them. “I can try to make sure you are healthy. And I can see about finding you shelter. But I need to get you more help if you are serious about having the baby. Number one, we need to finish the exam.”
“Can I get vitamins?” the girl asked. She touched her belly. “I want the baby to be healthy.”
“Of course.”
“I’ll take care of her,” the fifteen-year-old boy repeated. “I’m going to be a good daddy. Not like my parents. We’re going to take good care of our baby.”
When the two left, they were holding hands. They had waited several hours while we tried to find them shelter, but there were no openings. She was on a waiting list. In her hand she carried a bag containing prenatal vitamins. Vitamins and nowhere to sleep, I thought.
I remembered when I was fifteen. I could never have imagined myself as a father. I didn’t think I could have even imagined anyone else as a father. The idea that this boy would think he was capable of fatherhood should have been appalling. Yet at the same time I understood. The boy was reaching out for one thing in his life that had meaning. So was the girl. Since the beginning of time people have had babies, I reminded myself. Sometimes they were younger than these two and facing harder odds. People had survived much worse. Maybe these two could make it work. But still, I thought, they were children having children.
“Jan, do you ever think about the odds these kids have?” I asked her as she labeled the girl’s blood work. Her eyes were sunburned around where she had worn sunglasses.
“Like those kids, two teenagers having a baby,” I added.
“If it was one of my kids, I’d hit the roof.”
“I know you would.”
“But I’d still love them.” Her face got softer. “I guess I’m always just hopeful for the best.” She looked over to the sunlight rectangle of the door. More kids were approaching.
“Me too,” I said.
Life on the van hurtled forward as always. I found it hard to believe that January 2008 was here. Eight years had passed since we started the van. In 2007 I had been able to hire a new nurse, Julie Watson. She was an outstanding nurse, and Wendy and Michelle were over the moon that they could now do case management duties without having to cover medical issues.
All the same, I could tell that Wendy was beginning to dread our team meetings. She was still profusely apologetic for not being able to get Nicole help. We had been seeing Nicole now for two years, a lifetime for someone of her needs to survive on the streets, and every effort to get her help had been fruitless. During this time we had watched helplessly as she slid more and more into psychosis. Wendy had called the local inpatient psychiatric unit. She had called everyone, from social workers to the courthouse. They had told her what everyone else had said. Nicole couldn’t be committed against her will unless she went through extensive court proceedings and was found to be a danger. And she couldn’t get voluntary help without identification, which, of course, wouldn’t happen as long as she was psychotic. She was trapped in a system that punished her for her own mental illness. Wendy refused to accept this, and I understood how she felt.
I felt the familiar stab of helplessness. “You can’t blame yourself for the system,” I told Wendy. “The system is not set up for the mentally ill, whether they are adults or children.”
Wendy’s blond head dipped. “I just wish there were something.”
“I know,” I told her, wishing I could offer more.
“More requests,” Jan said, and we all groaned. Jan was always answering the van’s phone and hearing requests from agencies that wanted us to bring the van around: adult shelters, schools, soup kitchens, and alcohol and drug treatment centers. The problem was we had only one van and one team. We were limited by our budget and by our staff numbers. Every day we took out the van it cost a few thousand dollars in overhead for upkeep, salaries, supplies, and medications. That meant every new site we added came with costs. I tried to weigh the number of kids we served at each site against the chance that we could get funding, which mostly came from grants. My big dream, spoken to no one, was to get another doctor on board. Then we could split shifts and reach twice as many kids. But that also meant somehow coming up with thousands in extra funding. The way the economy was heading, I didn’t think that would happen.
“This Darlene Newsom just won’t stop,” she said. “Do you know her? She told me yesterday you did.”
“I’ve met her. She’s a total dynamo.” I had met Darlene at a task force on homelessness. She was a bright, grandmotherly-looking woman with a cap of silver hair and boundless energy. She walked with a slight limp, but I had heard she loved to go hiking in the mountains.
“She calls at least once a week and tells me to tell you one word: UMOM. What is that anyhow?”
I laughed at her persistence. “UMOM is her family shelter. It stands for United Methodist Outreach Ministries. I haven’t been there, but I understand they serve homeless families.”
“We go to domestic violence shelters. Why not them also?” Jan argued.
“It’s a matter of time and staff. We’re already working overtime.”
“She did say they had a lot of babies.”
“OK, OK. I’ll head out there today and check it out.”
UMOM turned out to be in a run-down area outside the city. I turned in past a high fence with a gate to find an old Motel 8, with peeling paint and concrete stairs up to each row of rooms. As I pulled
into the parking lot, I noticed a fleet of gleaming RVs parked at one end. A beaming Darlene stood outside to greet me and to give me the grand tour.
She started by showing me the shelter’s catering business. I was impressed. What had been an old kitchen had been converted into a shining, well-run professional kitchen. Darlene explained that the homeless parents who stayed at UMOM could work in the catering kitchen. They not only got job experience but also passed their food permit tests. The company’s catering was in high demand. It catered a lot of weddings and business meetings. It also fed the residents, and it was all done under the supervision of a professional chef.
Darlene moved on to the next room, the career and educational center. It was small, with rows of computers on tables and folding chairs. She explained how she had volunteer tutors come in. Most of the parents who came to the shelter had no high school diplomas, and some were illiterate. The tutors educated the parents, helping them study for their high school diplomas and, in some cases, helping them get scholarships for colleges.
“We have strict rules here,” Darlene said over her shoulder. She was walking so fast I had to trot to keep up. “Each parent gets a room for herself and her kids. No drugs, no criminal activity, no violence. I have way too many parents waiting to get in here to put up with nonsense. They all know that.
“Did you see all the RVs parked outside?” Darlene asked as she went past a day care room. “Those are mission volunteers. They travel the country in their RVs. They contacted me and asked if they could stop here for the winter. They’ve been doing everything from painting tables to helping in the kitchen.”
She led me up a flight of stairs. “I do wish the rooms themselves were bigger,” Darlene said apologetically while knocking politely on a door. “But that’s what you get for taking over an old Motel 8.” A young black woman answered, balancing an adorable baby on her hip. “This is LaShondra,” Darlene said. “And this is her baby, Chantel.” LaShondra gave Darlene a big sideways hug.
“I got my food handler’s license!” she exclaimed.
“Do you mind if I show Dr. Christensen here your room?” Darlene asked. “He’s going to be helping us.” I shot her a wry glance.
The room LaShondra called her home was really a small square box. There was no kitchen, no bedroom. On one side, crammed against the wall, she had her bed and a crib. In the middle was perhaps two feet of free space, and then on the other wall was a bookshelf crammed with children’s books. A television was perched on the end of a table. Food supplies were stacked in neat boxes on the floor. I saw cereal, bread, peanut butter, and powdered milk. It was all food that could either be eaten without cooking or made on the little hot plate resting on the bookshelf. We peeked in a dime-size bathroom with a faded shower curtain. There was a clean saucepan sitting in a drain on top of the back of the toilet, along with a scrub brush. This tiny sink was where LaShondra did her dishes.
Despite her humble surroundings, LaShondra wouldn’t stop telling me how wonderful UMOM was and how much Darlene had helped her. “I was sleeping with my baby in a bus shelter before I came here,” she said, scooping up her little girl for a big hug.
“If you don’t mind my asking, how come you were homeless?”
“My whole family is in gangs. They were shooting each other. I don’t want that for my baby.”
“How old are you?” I asked.
“Eighteen. But now that I have my food handler’s card, I’m getting a job. I’ve been applying everywhere.”
After we left LaShondra’s room, I began to tell Darlene how impressed I was with UMOM. It had surpassed any expectations I had for a family shelter. She stopped me. “You know what we don’t have, Randy? Medical care for babies like Chantel. Did you know that sweet little baby has yet to have all her shots? Just think of that.”
“You’re guilt-tripping me.”
“Of course I am.”
“Look,” I told her, “I’d love to stop here. But the van is already fully booked as it is, and we have a waiting list of places that would like us to visit. I just don’t have the funds to add UMOM as a stop.” In 2006 we had expanded our staff and the number of clinics—stops—we made with the van. The CEO of the children’s hospital, Bob Meyer, had asked me to think about having teams staff not just the van but a fixed clinic at the HomeBase center too. It had been a time of big, risky growth, and we were swamped with requests. It would be impossible for me to go back to the administration and ask for more money.
“What if you had your own little clinic here? With a nurse? She could have her own little space, and you could super vise it, since you’re the doctor.”
“That would be a dream.” I smiled, thinking Darlene probably had no idea of the start-up costs of creating a clinic, let alone hiring a nurse. “But again, I just don’t have any money to do something like that.”
She looked unfazed. “We’ll see about that.”
“Hi, Becca.” I had to remind myself this was Nicole, a teenager of perhaps nineteen. She was so convincing in her personalities I sometimes felt I should keep separate files. Today Becca was in a bubbly, fun mood. She let me check her ears and take her blood pressure. She was acting goofy.
“Knock-knock,” she said.
“Who’s there?” I asked.
“I forgot.” She giggled. It was strange hearing a knock-knock joke come out of the mouth of a teenage girl with tangled hair.
“I’d still like to give you an exam,” I told her. I expected her to say no. This time little Becca smiled.
“Sure,” she said.
I was caught by surprise. “I’d like to do what we call a pelvic exam as well,” I said.
“Okey-dokey,” she said, giving me that gap-toothed grin.
I called in Jan. I had never approached a pelvic exam with more trepidation. I wished I could explain to the real Nicole, whoever she was, what was happening. But instead I was talking to a little child. Jan got out a gown and asked her to change. We waited a bit and knocked. Jan went in first, talking quietly. I gently explained what I was doing as I came back in the room and pulled on the gloves. I rolled the stool closer to her. I reached for the speculum. And then I stopped.
Where Nicole’s genitals had been there was something else. I felt my eyes blink. Outside my doctor’s demeanor was calm. My doctor’s voice and eyes stayed even. But inside my heart was breaking open and weeping its own tears. I didn’t want to think about how or why this had happened. I didn’t want to think about the nature of these scars. What I wanted to say was, “Oh, you poor baby.” But doctors can’t talk like that.
I cleared my throat. “Becca—”
“You’re probably wondering about my owies,” she said in a crystal-clear little voice.
“Yes,” I said.
“My stepdaddy did that. When he was punishing me.”
Jan and I stared at each other. I didn’t know how to continue. But I did. I took the Pap smears. I dropped the swabs into vials. I finished the exam and pulled off the gloves. I gave the vials to Jan. I told Becca she could get dressed. The little girl in the grown woman’s body bubbled.
“Am I healthy?” she asked, sitting up.
“Healthy as a horse,” I said.
“See? I knew I was brave enough to do it.”
Afterward I went in the bathroom and washed my hands. I splashed water on my face, feeling the hotness of my eyes. I felt so sad my heart ached inside my chest, and the tears threatened to burst out. I wanted to cry for Nicole and all the hurt children, but I knew that if I did start crying, I would never stop. How could life treat this child this way? I asked myself. How could people do such things? The horror of it hit me. I looked in the mirror. The face that looked back at me looked bleak. When I came out, Jan was leaning against the wall. For the first time I saw her weeping. Her shoulders were shaking. She wiped her eyes when she saw me and walked back up front.
At home that night I pulled Charlotte into my lap. It was hard to believe she was almost four. She kic
ked her legs and nestled her face against my chest. She smelled like fresh-baked bread; she always had, since she was born. She babbled. Charlotte had the cutest little voice, with just a touch of a lisp. Just like Becca, I thought involuntarily. All the memories of the day flooded back: seeing Becca’s scars, seeing what could be done to a girl, seeing with my own eyes the travesties and pains of the world. I held my own little girl in my lap. For a moment a dizzy sick wave came at me.
“Are you OK, Randy?” It was Amy; bless her, Amy who seemed to know intuitively when any of us needed her.
“I’m fine,” I said without thinking.
Charlotte was still babbling. She was just a baby, I thought, and then corrected myself. She was a three-year-old little girl. What if what had happened to Becca happened to her? What if it happened to Janie or Reed? It wasn’t just the girls. So many of the boys I saw reported they had been molested. It could be a neighbor, a coach. Amy and I could die in a car accident. One of us could fall ill. Our children could be molested without our knowledge. I wanted to push the thought aside, but it kept intruding. You do everything in your power to prevent the unthinkable, I told myself. I remembered when the twins were in the hospital after they were born and how I had considered the impossible, that they might die. Now all the other what-ifs came rushing at me. My babies could get hurt in unspeakable ways. I knew nothing could be ruled out for good. And now this thought included molestation. I held my baby girl in my lap, our beautiful moment tainted.
Amy caught me that night. “Randy, you’ve been quiet for hours. Something is bothering you. You promised me that you would start talking to me.”
“I thought I was doing better,” I said.
She smiled. “You have been. You just still need a little reminding.”
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