Ask Me Why I Hurt Read online

  Mary stopped in the middle of the concrete lid. She waited expectantly. I looked around.

  It wasn’t until I was right next to her that I looked down. I saw what she meant. There was a small square hole in the top of the concrete lid of the overflow trap. The hole was barely large enough to admit someone her size. I knelt and peered in. The inside of the storm drain was a concrete slot, a sewage trap, bordered by dank concrete walls. The bottom was piled with dirty rags and food wrappers, some stuffed into the drainage pipes. To keep out the rats, I thought with a dismal, sick feeling. It looked like the den of a small, frightened animal. It was exactly the size and shape of a coffin. This was where our little Mary slept. This was her cozy home.

  I stood, reeling. I knew I was staring off in the distance. Tears stood in my eyes. I couldn’t speak. Mary waited, like a child expecting praise. A faint look of worry crossed her face, as if she were contemplating the possibility that I might not like her home. I could picture her there every night, crouched, eating food pulled from her pockets, food that had been culled from Dumpsters, the bag of peanuts I had given her that day. I could imagine her trying to sleep curled up against the fearful noises of the dark. I wanted to whip around and ask her what had happened in her life that had led her to this concrete hole. The injustice of it seemed so wrong. Part of me rebelled. There is no reason for a child in our country to be living in a hole, I thought. But then I looked down at Mary, standing next to me. She was a dirty, damaged-looking teenage girl living in a drainage pipe. She barely came to my shoulder. The same shadow crossed her face. She looked worried. She had shown me her home because I had shown personal interest in her, because I had acted as if I cared. Her gesture was one I could not ignore. Mary had reached out to me. I had to reach back, and the way I did it would show her either my respect and caring or my lack of understanding. It is the first time she has opened up, I thought. Maybe this is the beginning. Maybe I can do this. I knew that whatever I said next was of the utmost importance.

  “I’m glad you showed me your home,” I said, my voice hoarse.

  Back in the truck Mary fiddled with the window buttons, just like a young kid. I was weighing what to say. Something had happened to her that was so traumatic she had either stopped remembering or deliberately tried to forget. I felt that she was hiding from something or from someone. She was hiding not only psychically but also physically. Why else would she have retreated to this hole in the desert? I had realized that asking her blunt questions would only earn me silence or that panicked, blank expression. On the other hand, I could not afford to take more time. I couldn’t be patient. Not when she slept in a drainage hole, not when every day was a risk for her. Time was running out against the day when something bad would happen to her. When I thought of her spending one more night in that hole, it hurt inside.

  I turned back to her. “How long have you been sleeping out here, Mary?”

  Mary got the strangest look on her face, like an anxiety attack in reverse, a sweeping away of memory that took her to a place where no one else visited. She blanked out. Unsure, she stared out the window, blinking. “I don’t know,” she said slowly. She looked up at the sky through the window. Her face told me that she honestly didn’t have the answer. Time, just like her last name, was something that Mary was trying to forget. Just like whatever had happened that had chased her to where she was now.

  When we got back to the van, gently I tried to talk Mary into staying or at least into telling us her full name so we could figure out more ways to help her. But she quickly ran off again, toward Mill Avenue. My stomach was in knots, and I felt depressed. I thought, How can I help them when they keep running away?

  It was another late night. It was almost 10:00 P.M. by the time we got the van parked back in its loading dock that night, safe behind a high locking gate. Jan’s usual cheery good-bye seemed muted. I was so tired I kept relocking the gate before I realized what I was doing. My eyes were burning with exhaustion, and I felt unshed tears.

  I stopped in at the children’s hospital to check my work there. I was still a staff physician and had many responsibilities, including the supervision of medical students. Instead of being able to go straight home I had to check e-mails and messages and notes. I sat at my desk, feeling the cool silence of the hospital around me. That late it was quiet. I opened my computer. The e-mails and notes waylaid me. There were conference invitations and meetings and a diabetic camp that needed a director. I was facing upcoming certification tests in internal medicine and pediatrics. The thought made my stomach suddenly roil with anxiety. The certifications would require hundreds of hours of study. How was I going to find time to do that? What if I failed my tests? My job might be in jeopardy. My peers might say I wasn’t up to the work. If I failed the test, I’d be humiliated and judged by my peers. By taking on the van I had added one huge responsibility to my workload without reducing anything else. The panic gremlin scurried up and gnawed at my stomach. It told me that I had not planned this well. Not at all.

  Just stop worrying, I thought. Go home. Eat. Sleep. See Amy.

  I crawled into my truck. The dashboard time blinked at me: 11:13 P.M. I would have to be up by 6 A.M. I drove home in the desert night, the wind like black silk outside. Tidy, uniform bungalows passed by. So many lights were already out. Other people were safely tucked in bed.

  But I knew Amy would be awake. She would be waiting for me in the kitchen, sitting at the counter, flipping through a magazine, a mug of tea at her side or an empty dish of her favorite ice cream, peppermint. Her hair would smell like vanilla and coconut shampoo. She would have changed into a pair of my boxer shorts and a matching clean cotton shirt. It was something I found touching about Amy: if she couldn’t find a shirt to match my boxers, she would change. It was only nighttime, and no one but I would ever see; still, the boxers had to match the shirt.

  I was looking forward to our sitting together for a few minutes and telling each other about our days. It was a profoundly comforting thought.

  The next day the boy who had almost died from pneumonia and blood infection stopped by the van while we were parked in downtown Phoenix. The hospital had released him, and he was back to being homeless and sleeping under bushes. It was strange to see him looking so healthy after he had come so close to death. His brown hair was shiny, and his face was calm. Without the shroud of sickness he was even more handsome than I had thought. The blue eyes that had been blinded with shock were now clear.

  I took his vitals. Once again they were normal; only this time I knew they were true vitals. “Are you having any health problems from the infection?” I asked.

  “Naw.” He sat on the exam table, hands calm on fit legs. He still had the athletic build of a football player, with broad shoulders under his T-shirt. “I can’t believe I was almost dead. That’s what they told me at the hospital. Is that true?”

  I nodded.

  “Wow,” he said in a muted voice. “I came that close.”

  “You did.” I listened to his lungs. After such a severe pneumonia we would need to pay close attention to his lungs. They might not heal well. A bad pneumonia can cause adhesions that lead to collapsed lungs. In some cases patients lose parts of their lungs.

  “No white light,” he said, laughing nervously. “But you know what I remember?”

  “What do you remember?” I asked. I moved the stethoscope to another place over his lung fields. He winced a little at the feeling of the cold metal. I listened. So far so good. His lungs were clear.

  “This guy out in the desert who told me about a van called the Big Blue. I thought it might be a dream when I saw you parked here. I don’t really remember you at all. Are you the one who helped me?”

  “Me and Jan. She’s the nurse-practitioner out front.” I moved the stethoscope again for another listen. “Take a deep breath for me.”

  He breathed. “Doctor?”

  “Yes?”

  “I can’t believe I almost died.” His clear blue
eyes met mine. There was a grave realization there. He knew he had almost died. I wanted to tell the young man about the first time I had touched death and how much it had influenced me. It had been only ten years before but felt like yesterday. I had taken the year off to save up money for medical school. I was working for a drug company in San Francisco. One day my bosses sent me to Tucson to pick up supplies. I had lived in Tucson from age ten until my college years and was looking forward to the visit. Coincidentally, there was going to be a party in Tucson for the new members of my fraternity, Kappa Sigma. I thought seeing old friends would be good, especially since I’d been feeling down about not being able to start medical school right away. I was standing in the middle of the courtyard between the cheap little cottage apartments that the guys in the fraternity used to rent, talking to an old friend. The sky was black and starry. It was one of those hot electric summer nights when you just feel there is going to be trouble. A strange man suddenly appeared in the middle of the party. He had wandered in off a busy downtown street. He began arguing loudly with my companion. I wondered if he was drunk. I moved to intervene when there were shouts. Another man had come into the courtyard, and it was with disbelief that I saw he had a gun. He was pointing it at the sky and shooting as he came straight at us. The sound was strangely anticlimactic yet chilling, little popping sounds in the night. Instinctually everyone ducked and panicked. None of it made any sense to me, but without thinking I moved toward him, gesturing peacefully with my hands. “Drop the gun,” my hands were saying. Behind me police cars arrived, and officers came running. I was thinking, This makes no sense. Why is someone with a gun here? How did this happen, and so fast? The police must have been looking for this guy. One of the officers dived for the gun. Shots rang out. Others chased the shooter out the back entrance as the officer collapsed next to me.

  I crawled to him. There was a jet of bright red blood coming out from under his armpit. I knew this was arterial blood, from the heart. He made no sound. His face was quickly turning blue-gray. There was no pulse. I tore open his shirt only to find a bulletproof vest underneath. How had the bullet gotten through that? With my hands I felt under his arm. The bullet had entered right under his armpit, in the one place not covered by the vest. I tried to do CPR, but with each compression a big squirt of blood came out of his armpit. How do you get these things off? I thought in panic. Blood was pouring out, bathing my hands in thick warmth. I shouted, and someone handed me a towel. With my fingers I pushed it into the wound, trying to stop the bleeding. But within moments the end was clear.

  They pulled me off his body. I was taken to a police car, where I sat for three hours, waiting my turn to be interviewed. “What was his name?” I asked the officer sitting in the front. He wiped his eyes before answering. They had worked together, I thought. “John Barleycorn.” It sounded so American, so innocent. The death of Officer Barleycorn was a turning point in my life. My own problems suddenly seemed small in comparison. I realized how quickly someone could lose it all. I had tried to save someone and failed. But what I remembered most was the sudden realization of how precious life was and the reality of the man in front of me in flesh and blood and how desperate I had been to save his life. From then on it seemed life was more meaningful.

  I wished I could tell the boy sitting on my exam table how being touched by death can inspire one to live a better life. I wanted to tell him he could use his brush with death to fight for himself. But the words just weren’t there.

  “You can put your shirt back on now,” I told him instead. “Your lungs sound pretty good. Your general health seems good. I want to get you a follow-up X-ray.” Suddenly I pictured a hospital bill. I realized this boy had no insurance. The hospital had seen him because it was an emergency. Without insurance, paying for an X-ray was going to be impossible. I worried that he might not be able to get the X-ray at all. I’d have to find out. One more thing to add to the to-do list, I thought.

  The question remained in his face.

  “I don’t want to see you sleeping under bushes,” I said. “We have some good friends who work at a place called HomeBase. They have a nice shelter for kids your age to stay at. I’m going to call them for you, OK? We’ll see if they have a bed.”

  “OK,” he said with a smile back.

  3

  TELL ME

  Mary was there when we parked again on the next weekly trip to Tempe. I suspected she had been lurking around corners from the early morning, just waiting for us. She appeared shyly at the bottom of the steps as soon as we parked, and Jan said, “Look who’s here. Come on up.” Jan gave her an extra fob chain to wear over her shirt. “She’s our new assistant,” Jan said. Mary looked delighted.

  She sat in the front, opening up bit by bit. I could see the relaxation in her shoulders and a tiny smile peeping out of the corners of her mouth. Once or twice that morning Jan made a joke, and Mary’s eyes lit up, while I saw other patients, darting in and out of the rooms. Coming out once, I was startled to hear Mary laugh. It was a bright, sharp laugh that made our heads turn. The other homeless kids accepted her presence without comment. I realized that some things were sacred with these kids. Mary’s need for family resonated with them. They understood. No one questioned why the tiny girl with a fob chain sat all day in the front of our van.

  That day she let me give her a physical exam and do blood work. She fidgeted during the physical, looking abashed. “We’re glad you’re here,” I told her, and didn’t pick up on why she seemed even more uncomfortable than usual.

  Jan came in to take the blood. She took one look at Mary and figured it right out. “Can I talk to her?” Jan asked. I left the room. Jan told me later she gave Mary a girl talk about periods and using sanitary napkins. “She was using wadded-up paper towels from the public restrooms,” Jan said when Mary went outside. She lowered her voice. “She’s so out of touch with her body. She doesn’t even know why she has periods. I tried to tell her, but she shut down.”

  We both looked to where Mary was now sitting outside, her exam over. She still wore her bracelet. “Ask Me,” it said, and I hadn’t yet. I was afraid I didn’t know how to ask. How many weeks had passed since she had first started coming to the van? Too many. What if I just scared her more? What if she left and never came back? I realized that I was better at helping the kids with their medical needs. It was everything else they needed that I didn’t know how to handle.

  She sat outside in the heat, sipping water and watching the other kids play. Jan had given her a white bag with extra sanitary napkins, and she held this in her lap like a prize. This made me ache inside. I thought about her going back to her hole once again. I made phone call after phone call in between patients, trying to find help for her. I was shocked at the lack of resources for kids like Mary. I wanted to argue with the people on the phone. “She’s living in a hole,” I wanted to yell. “We’re sorry,” they said, and behind their voices I heard budget cuts and high caseloads and people sick with stress themselves over all the help they wished they could give but could not. I said I understood. I did understand. None of these people was making it rich by denying homeless kids. All of our hands were tied by lack of money and other resources.

  I put my phone in my pocket and looked out the door, and Mary was gone. I stepped outside and looked around. Once again she was gone. “Mary,” I wanted to yell. “Come back.” I went home feeling sick with worry. I can’t keep doing this, I thought. I felt like a failure. Someone else would have saved her by now. A better doctor would have helped her. I waved good-bye to Jan that night, knowing that she too carried that weight home on her shoulders. When I curled up next to Amy that night, I thought about Mary, living in her hole. I had a dream in which I went and rescued her, and when I carried her out, she was as small as a kitten. I woke in the night with longing. If only it was that easy, I thought. If only.

  The following Monday I gave Mary a set of brand-new clothes, including socks and shoes. The jeans were dark blue Wrangl
ers, stiff with newness, and the shirt had a pop star on the front. It was a nice, fashionable outfit, the kind a teenage girl could wear without shame. Afterward she sat on the paper-covered exam table, pressing her new jeans with her hands and giggling. I had never seen her act so much like the child she was. She seemed all of twelve. I imagined her having sleepovers and talking about boys and eating junk food. She had missed so much from life. Was it possible to give any of her childhood back to her? Or was it more important to help her find her way as an independent adult?

  “Look at you, with those nice clothes. Now you’re ready for a new life,” I told her. She blinked, as if this idea had never occurred to her.

  I thought about what to say. I needed her to talk to me. I had been taught not to get too involved, not to care too much, to keep a professional shield between the patient and me. “You don’t want to get too close” was the mantra of the medical field. I remembered that, encouraged by my friend Danny, I took the special medical program in high school. I soon found myself going to actual surgeries and teaching rounds. I was able to shadow heart surgeon Dr. Jack Copeland. I was very lucky; Dr. Copeland and his team were often in the national news. I couldn’t believe I was sitting in on their meetings. During one, Dr. Copeland turned to me and asked, “Randy, can you research this technique?” I stayed up all night writing the report.

  Most of Dr. Copeland’s patients were older, but there was one teenage girl, who was sick with a failing heart. She needed a transplant. She was on the waiting list but grew sicker day by day. Her name never seemed to move up the list. It upset me that a girl my own age would be so close to dying. I sat by her bed, feeling gawky and adolescent and all arms in the new striped shirt my mom had bought just for my new job. My wrists seemed too long, my neck was too thin, and at that age I never seemed to gain weight no matter how much I ate. My voice kept cracking. Still, she seemed to like my company. We talked about the average stuff: music, bands she liked, how she wanted to learn ballroom dancing even though it was kind of nerdy.