It has been about a year since we moved out of the “inner city.” It’s an experience we are still processing with many mixed feelings, among them relief, disappointment, and shame. It is a relief to be able to walk around the block without fear of hearing gunshots, to sleep at night with working heat and running water in the winter (since the pipes don’t freeze here), to not wake to banging noises wondering if we are being broken into. It is disappointing to feel isolated in our rented apartment, that even though our neighbors are friendly and engaging, our interactions tend to be brief and largely disconnected. And shame… I am still not sure why we feel that but we do.
My wife reminded me that it has now been one year since we were last broken into. She was partly reminded of this because our car was broken into last week, an incident in which only a cheap phone charger and several quarters were taken. This occurred despite having moved to a “nicer” area of the city, one in which we easily enjoy walks in the park and Greek festivals and fancy burritos. It is a neighborhood where we can walk freely, a stark contrast to our old one where I whimsically described myself as sticking out like a Chinese thumb on a black man.
In the first post of this series, I was ruminating about a patient who had a rapid decline in health and social circumstances, culminating in a recent scan that showed the possibility of cancer even while he was struggling with homelessness. It was a bleak situation that caught me off guard because I was not expecting it and was grieved to think of what it would be like for him to die alone.
He has since died.
It was stunning news. I listened with disbelief as my colleague described how a patient of ours, in whom we had uncovered a host of serious diseases over a few years, was now newly diagnosed with cancer after an incidental scan. In addition, his social supports had been eroded and I thought about what it would be like for him to die from a vicious terminal disease while alone and homeless. He would not be the first patient for me to watch die in such a way.
Last Saturday I tried to go to work early and catch up on some paperwork. The building was not yet unlocked, so I went to the diner across the street for some breakfast.
I ordered the $3.25 breakfast, consisting of a carb (2 slices of white toast), a vegetable (fried potatoes), and a protein (2 fried eggs). The man at the counter a couple seats down ordered the $5, which added sausage and subbed in french toast for regular toast. Apparently he was too hungry to wait, and decided to order a muffin while his food was on the grill. I believe it was a blueberry muffin. And I believe the muffin contained as much, if not more sugar as flour.
I stopped and put my fork down on the plate. There was still food on it, but an emotional force had interrupted my appetite. My wife and I had been sitting at the dining table, chatting idly about preparations for our child, now nearly 34 weeks old and still in the womb.
34 weeks. In the mere act of thinking those numbers, my mind suddenly brought out memories of many other children I had seen with those same numbers attached. 34 weeks but still with an unexpected high-grade intraventricular hemorrhage. 34 weeks but with panhypopituitarism. 34 weeks but with neurologic devastation. 34 weeks but…
I haven’t exercised in several years. Really, the only time I run these days is when someone is literally dying. I run to Code Blues in the hospital. I run to stat messages on my 1980’s style pager. And that’s about it.
It’s shameful. I’m a physician who routinely counsels children and adults about the benefits of exercise and the importance of maintaining a “healthy lifestyle”. Consequently, I often feel like a hypocrite because I grouse and mutter and make excuses when my wife encourages me to do something active. It’s ironic because most people who see and know me shake their heads and say that I should gain several pounds.
The drug dealers around the corner work long hours, rain, snow or shine. Sometimes they purposely look away when I walk by. Sometimes they say hello/hi/good morning or “Do you have a light, ma’am?”, to which I respond, “No! I don’t smoke. And you shouldn’t either!”. Sometimes they look like hardened criminals with their lower orbital tattoos. Sometimes they look pitifully vulnerable sipping on a Capri Sun. If you’re sipping on a Capri Sun, I’m gonna have a hard time taking you seriously. Victor is one of the local dealers. I met him a year and a half ago.