Ask Me Why I Hurt (21 page)

But I was glad to see Amy out and about. She was taking care of two preemies all day and night every day. I thought this was a
time when she probably missed her mother. She didn’t have a lot of female relatives or friends nearby. That night I called her mother’s cousin Jo Ann in Virginia. She was in her late sixties and had known Amy’s mother well. “Can you call Amy? Offer some support for a new mother?”

Amy was overjoyed to hear from Jo Ann. “We talked on and on about the babies. Sometimes I think being a doctor and a mom makes other women afraid to give me advice, but Jo Ann wasn’t at all.”

“How great to hear from her,” I said.

Amy gave me a big hug. “Jo Ann told me it was you.”

“Does that bother you?”

“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 the 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.