Ask Me Why I Hurt Read online

  I fell into the doctor role, smiling and calmly explaining the physical as I went. First I checked her eyes and ears and the lymph nodes of her neck and head. I listened to her heart and lungs. “Can you lie down?” I asked, and she reclined slowly and, I thought, suspiciously. I felt her abdomen for liver, spleen, and masses. She looked away, tuning me out. She kept her head turned. Her body was tense when I touched her. I couldn’t tell if it was because she had pain or because she was emotionally uncomfortable. “Does that hurt?” I asked as I gently felt her liver area. She gave a quick shake no. She doesn’t want me to touch her body, I thought, and quickly finished.

  I stood back. Mary’s general physical health seemed good. She was slightly malnourished. She had a lot of scrapes and bruises.

  “How old are you, Mary?”

  There was a very long silence. “I don’t know,” she whispered.

  I stopped when I heard that. She had spoken so softly. Instantly I felt my own voice soften.

  “Don’t you remember when you were born?”

  She didn’t answer. The blank quality to her face gave her a strangely ageless look, like a blurred photograph. She could have been eighteen. She could have been younger.

  “What’s your last name?”

  She turned her head away and looked out the exam room window, to where dusk was falling rapidly. The sunset had tinged the blinds orange and purple. It was as if a curtain had fallen over her features. She tucked her hands inside her legs. I felt a sudden, completely unexpected flood of emotion. Maybe it was the lack of animation in her face and the emptiness and despair it suggested. Maybe it was the slightness of her body and how young and vulnerable she seemed. I had come for this, but the reality was not what I had expected. It hit me in my gut. This child had no home. She would not bounce off my table and return to the loving smile of a mother or father. She would leave my van—for what? What was waiting for Mary outside on the streets?

  In that moment I thought of my little sister Stephanie. I remembered one Christmas when Stephanie was about three. Wearing a Christmas red smock, she was sitting in a tiny chair under our fake white tree. I was standing by her, proud to be a big brother. The memory was as bright as a snapshot. Then another came: Stephanie, diagnosed with multiple sclerosis, rising from her hospital bed in a Christmas red nightgown, leaning on a walker. As the doctor in the family I was the one who broke the news to my sister and helped in her treatment. Mary reminded me of Stephanie in some way. Maybe it was the sense of vulnerability about her, the feeling that under this blank exterior a real girl was hiding.

  “Do you have a place to sleep, Mary?”

  “Sure,” she said. Her eyes slowly moved toward mine.

  “Couch surfing?”

  There was no answer.

  “Do you have any identification, Mary?” She shook her head no and gestured toward her grimy jeans pockets, as if to turn them inside out. I had discovered in the past week, much to my shock and frustration, how much identification mattered. Identification was the key to unlocking so many services, from housing to employment to education. Yet very few of the kids had identification. Why would they? I thought. Not many homeless children are going to have driver’s licenses. It was a major stumbling block for getting help.

  Mary got up as if to leave. I wanted to talk her into staying, but I felt if I pressured her, she would bolt for good. Outside the exam room I heard voices. Jan was dealing with a new group of freshly arrived kids, telling them we needed to close down the van for the night. She was telling them we would be back at this site next week, that tomorrow we would be in Phoenix. There was a chorus of complaints.

  I looked again at the intake form Jan had filed out. Mary had answered few of her questions. “Says she has a headache,” Jan had written, with a question mark after it. That was our new code for suggesting that maybe the kid was using one complaint to get help for another problem.

  I gave her some Tylenol. She smiled at me for the first time, a shy smile that she almost immediately hid behind her lips.

  “Can I make some calls for you, Mary? Is there anyone in your family—”

  She looked alarmed, shook her head rapidly, and began edging toward the door. For the first time I saw panic on her face.

  “Hold on,” I told Mary.

  I got her a pair of fresh socks and a hygiene kit, which contained a toothbrush and soap, as well as bus tickets and brochures for help. I handed this to her up front.

  “Come back please,” I told her.

  For a moment she stood there, and in the final vestiges of sunset I again thought of my sister. Could Stephanie have survived on the streets? I knew the answer: of course not.

  Jan and I watched Mary walk off toward Mill Avenue. She was small and slender under the large dark sky. She looked no bigger than a child and walked quickly, as if afraid of the coming night. She carried the bag with supplies under one arm. I didn’t want to think of what awaited her on those streets.

  “She’s just a baby,” Jan murmured.

  I nodded.

  “What’s her name again?”

  “She said it was Mary.”

  “That’s right. She didn’t really have a headache, did she?”

  I shook my head, “I don’t think so. I think what is wrong with Mary is much worse,” I said. “But I can’t say what it is. She wouldn’t talk to me.”

  Jan nodded. “If only headaches were the only problem these kids had.”

  Night was falling, driving a final sweep of colors across the sky. Soon the stars would come: bright desert stars. The streets had fallen into that peculiar desert silence, permeated with clicks and buzzes and insect sounds, yet seeming utterly still. Mary’s figure retreated until it was just a small shape, and then she turned a corner and was gone. From down Mill Avenue came the faint hoot of music from a bar, and in the distance there was a sudden blast of a car horn. I felt a tremendous guilt. If I could, I thought, I would lock her up to keep her safe. I looked at the stars and made a fervent wish that Mary would travel safely into the next day.

  “She could be my daughter,” I said softly.

  Jan shook her head. “Heaven forbid, she’s someone’s daughter.” Jan had a son and a daughter, both teenagers. The sadness in her voice was clear.

  “Yes,” I said, this time with anger in my voice. “She’s someone’s daughter.”

  2

  MOEUR PARK

  The van was a disaster. The jacks kept malfunctioning despite repeated repairs. It seemed that as soon as we got one problem fixed, another cropped up. My dad came out several times, driving down the freeway from Gilbert to work on the engine. I’d call him from blighted urban areas of Phoenix or outside shelters or Tempe, and somehow he’d find us, tooling up in his little truck with his green army bag on the seat next to him. For as long as I could remember, he’d used that same oil-stained army bag to hold his tools. Soon he would be under the hood, grease smeared up his brawny forearms, a cap perched on his fluffy silver hair. The homeless kids adored my dad. They called him Gramps.

  But my dad couldn’t help with the biggest problem, which turned out to be the generator. It simply couldn’t produce enough power to run all the medical equipment and refrigerators and keep the air conditioning running too. I would be right in the middle of a busy day, up to my armpits in kids, and the generator would conk out. With a hiss the air conditioning would die. Without air conditioning the heat inside the van climbed to more than a hundred within minutes, and all our refrigerated supplies were at risk.

  One day, soon after meeting Mary, I was complaining about my general predicament to one of my best friends, Ron Couturier. His father was a member of a charity group called the Jaycees. Ron’s dad and friends had formed a group of older men who called themselves the Old Timers. “Why don’t we ask my dad’s group for help?” Ron suggested.

  I really didn’t want to impose on people, but Ron insisted, and so the following night I found myself knocking on the door of his house for one
of the Old Timers’ meetings. I had dressed up in a suit and a tie, my unruly hair brushed back. When I walked in, all conversation stopped. Sitting in a circle in the living room was a bunch of old cowboys dressed in worn jeans and dusty boots. After a few friendly laughs and jokes about my attire, I stammered into my speech. I stood in the living room and talked about how we were trying to help homeless kids with medical care, but the problems we were having with our generator were making it hard. The longer I went on, the more I felt my cheeks color. I was overly conscious of my stutter and tried to choose my words with care so the dreaded “uh-uh-uh” wouldn’t start. I wasn’t sure where I was supposed to be looking either, so I looked at one wall over one cowboy’s hat, seeing the brim under my eye and aware of everyone’s attention on my face.

  When I finished, the cowboys were polite and I thought probably embarrassed for me. They offered a slice of their pizza. I ate it without tasting it. I felt I hadn’t done well at all. Clearly public speeches are not your thing, I thought as I drove home, feeling the sweat still dampening my suit jacket. I had barely made it home when I got a call from Ron. He said the Old Timers had started writing the check as soon as I had left. I made a joke that it was probably out of pity, but Ron stopped me there. “They like what you are doing,” he said matter-of-factly.

  So the next day, from the generosity of the Old Timers, I was shopping for a new generator. It was too big to put inside the van; we had had to mount it on the back, and to start it, I had to go outside in the blazing heat and yank on a cord, like starting a lawn mower, sometimes for ten or more minutes. It wasn’t easy, but I wasn’t about to complain. I was just grateful we had air conditioning, and my sweaty exertions always gave Jan the opportunity to joke that I needed the exercise. She usually flexed as she spoke, showing off her buff muscles.

  A few days later we were back in Tempe, and in the 109-degree heat I was out behind the van, yanking on the generator cord. Arizona heat is an all-encompassing thing, more like a physical object than just air: it surrounds you like an inescapable blanket, sometimes so unbearable it is hard to breathe. The idea of the homeless kids being out in such heat waves, forced to walk blocks or even miles for food or shelter, frightened me. I immediately began pouring sweat. It ran into my eyes, stinging, and made a sightless wet fog out of my eyeglasses. My shirt was soaked. The sweat ran down my arms and dripped off my wrists.

  Suddenly I was aware of someone standing behind me. It was Mary. It had been a few days since we had gotten the generator and several weeks since I had first met her. She had come back once since, but the minute I started pressing her she had run off. I had felt sick at heart about it and resolved not to make the same mistake again.

  As before, she was alone. Most of the homeless kids seemed to move in protective packs. But Mary was alone.

  “Please wait,” I told her. The generator had finally roared to life. I led her inside. I couldn’t see out of my glasses and felt around for a towel. She sat in the front of the van, in the little intake seat near the door. She seemed to like sitting in the little chair. Mary’s face was a mask. She looked miles away, lost someplace behind the curtain of her eyes, as fearful as a small animal. “How are you today?” I asked. She looked at me suspiciously from the corner of her dark eyes.

  I felt a new awkwardness. When I worked in the hospital, it was easy to know how to act around children: I was professional with the parents and warm with the children, but I could always assume the parents would explain things to their kids and, if necessary, share information. With the homeless kids I wasn’t sure how to act. I needed to bridge a distance that didn’t exist in usual pediatrics. These kids had built fortresses around their hearts. They were not about to share with me secrets that they had never told anyone. Mary was so closed off that I didn’t think my usual professionalism would work. She seemed so shut down that I wasn’t sure if anyone could reach her. I can’t get across this divide, I thought. I can’t figure out how to get her to talk to me. I wondered if it would be possible to act professional yet also connect as a caring adult.

  I decided that for the moment I’d stop being the doctor. I’d drop that persona, and I’d just be Randy Christensen. “Whew,” I said, sponging off my face.

  Mary stared around the van. Boxes of gloves were mounted on the wall. Vials lined the counters. I often felt like a bull in a china shop, trying to maneuver around. When Jan and I passed in the narrow hallway, we both had to turn sideways. I handed Mary a pack of peanuts from the dashboard. She secreted it in her clothes. Everything she did seemed to be in slow motion, as if her movements were underwater. I saw her looking at the wall. Both Jan and I had stuck up a few personal pictures. One of Jan’s photos showed her winning a BMX trophy, her husband and teenage son at her side. Mary was staring at another photo.

  “That’s my wife, Amy,” I said.

  She stared at Amy’s wide smile, at the way her hair curled over her ears. She asked a question in a voice so low I almost didn’t catch it.

  “We don’t have kids yet,” I answered. The truth was Amy and I had been trying. We both wanted children. But that didn’t seem like something to say to a homeless girl.

  Her feet hung off the little chair, not even touching the floor. The soles of her low-top sneakers were cracked and worn. She had drawn designs in marker across the tops of her shoes, strange designs that made no sense to me. The bracelet was still on her wrist. She looked so distressed yet incapable of communicating. I was aware of myself as a big man, sitting across from her. Is it me? I wondered. Maybe a female doctor would be better. A woman might be less intimidating. I could hear voices outside. More kids, coming for help.

  “Where exactly are you staying, Mary?” I asked nonchalantly.

  She spoke suddenly. “I have a cozy place. A cozy little home.”

  A cozy little home? The phrase seemed odd.

  “That’s nice.” I spoke carefully. “Where?”

  The look of suspicion came back. “Moeur Park.”

  I knew Moeur Park, an empty slash of desert just north of where we parked our van. It was known for its homeless camps. It was not really a park, but rather a desert wildlife area protected by law from new housing developments. During the day hikers and joggers sometimes used the trails. But at night the homeless found shelter among the hills and desert shrubs. Although relatively near the city of Tempe, the area was secluded, and there were no police stations nearby, no homes, no one to hear a person cry for help. I knew that for homeless kids, violence was an expected part of life, and for a loner like Mary, Moeur Park could be especially dangerous. I shuddered inside to think of Mary alone, hiding there in Moeur Park. And what did she mean by a cozy little home?

  I asked her, even as I heard the tentative climb of feet up our steps and saw the long shadows cast by other bodies, knowing that soon I would have to turn my attention to the waiting children.

  “What kind of cozy little home, Mary?”

  “Oh.” She looked at me with a strangely hopeful expression, the first light I had seen in her eyes. “It’s a nice home.”

  “I’d like to see that sometime.”

  “Really?” She sounded as if she didn’t believe me.

  I didn’t want to miss this opportunity to connect with Mary. I asked her to wait while I took care of a few patients. Jan agreed to cover the van while I took Mary in my truck. Mary slid in the back. After being in the clinic all day, I felt the air conditioning of the truck with relief. Mary quietly sighed with pleasure. I heard a rustling. She was looking through all the fast-food wrappers in the back, examining them like artifacts. She held up one Arby’s roast beef sandwich wrapper, then another, and an empty curly fries container. I suddenly wished I had cleaned the truck.

  The scenery sped by. We were crossing the Mill Avenue Bridge on the way to Moeur Park. Below us was the man-made Tempe Town Lake, with serene, shallow blue waters. People were out paddling on the cool water and walking on the esplanade. I could remember when the lake had been
a dry extensive wash full of rocks, and the homeless had camped there. The new lake was pretty, but it had pushed the homeless even farther away from social services.

  “Here we are,” I said, as we turned into a small parking lot on the other side of the bridge. Someone had defaced a NO LITTERING sign with an obscene spray-painted picture. Moeur Park reached around us. A lunar landscape of sandy hills capped with shards of rocks and stunted cactus, it was the sort of place where you never knew—and maybe didn’t want to know—what waited over the next rise. Mary got out of the truck. She pulled a hank of her limp dark hair forward and stuck the end in her mouth with a blank expression. She nursed the strand of hair as she contemplated the expanse that was her home.

  I was struck again by how young she looked and how devoid her expression was of any emotion, any hope. Wordlessly she trotted off over the rocky hills.

  I followed Mary over several hills, until we were out of sight of the truck—out of sight of everything, as a matter of fact. The desert spread around us, the clear blue sky endless and daunting. The homeless had set up their camps in the washes, spreading old blankets and tarps over the bushes for shade. Abandoned sleeping bags and rags lay about like dead animals. The sandy ground was littered with broken glass. Lizards scampered over hot rocks. The temperature was still over a hundred. Mary seemed strangely impervious to the heat, as if something else had already sapped her energy and left her like this, desolate and empty. I could see no other people around. At night this was no place for a young girl.

  “Are we getting closer?” I asked. I had sweat rings under my armpits. Dust marred my new loafers. She stood at the top of a rocky cliff and pointed down a long valley cut between two hills. Thick desert bushes grew along the bottom. I slid down sharp shale, the thorny bushes pulling at my cargo pants. I felt the reassuring bump of my codebooks in my pockets. Mary didn’t answer. At the bottom she stopped on what looked like a concrete lid set in the desert floor. There were storm overflow sewers set in washes like this for when the torrential rains came. In Arizona’s monsoon season, it poured, and washes played host to flash floods. Even deserted areas were underlined with a network of storm sewers.