Authors: M.D. Randy Christensen
My first fund-raising event was at a Lions Club annual dinner. I had picked the Lions because their mission, which was to help people with disabilities, encouraged me. Their annual dinner was being held at a McCormick & Schmick’s seafood restaurant, and while the food looked and smelled delicious, I was too nervous to eat my Dover sole. I took the small stage and looked over the faces, turned up to me. Many of the members were elderly; quite a few were blue collar, and most were wearing their well-washed best, the men in bow ties and the ladies in flowing dresses, and there were more than a few military medals and pins thrown in. As always it amazed me how people from different walks of life spent so much time trying to help others. Few of these people probably had a reason to care about homeless kids. Yet they did.
I talked about some of the kids I had seen, taking care not to violate their confidentiality. The further I got into their stories, the more my voice choked up. I felt rather than heard the silence in the room. Finally there was applause. My shirt was soaked under my jacket, and when I opened my eyes, I saw everyone was standing. They were standing for the kids.
Afterward a man came up to me with a check for two thousand dollars. I guessed from looking at him that this was money he had worked hard for, and tears of gratitude filled my eyes.
G
o see who’s in the exam room,” Jan said. Sugar. It had been many months since I had seen her. She was sitting on the table, her hands between her legs. Her curly hair was long. It hung limply by her cheeks. Her face was down, pointing at her knees, which were clad in scuffed, torn jeans. I felt a surge of relief just that she was alive.
“I can’t stomach calling you Sugar,” I said, going in. “I think it is time you told me your real name.”
She turned her face up. She had been badly beaten. Her jaw-line was purple and swollen. Her lips were bruised and split. Her left eye was a purple mass. I felt myself gasp. “What happened?” I asked, my voice calm, despite my horror. “Who did this to you?”
She spoke through bruised lips. “John.” She said the word in a monotone. It took me a moment. His name wasn’t John. He was a customer.
“Someone you know? A regular?”
She shook her head. She trembled a little and pressed her legs together. I suspected then that it had been more than a beating. “It was a white guy in a van.” She gave a desperate little cough.
“Were you raped?”
She nodded, and the tears spilled. She tried to wipe them away. “Stupid.”
“You’re not stupid. You’re hurt,” I said, passing her a Kleenex. She wiped her face. When she leaned over, I picked up the stale, rank smell of fear, the kind of sweat that comes only when people are in terror.
“We’ll need to examine you. Would you rather have Jan?”
She nodded. The tears were flowing now. Her shoulders began to shake.
“Good, that’s good. I’m glad you’re thinking of yourself. When Jan’s done, I’m going to look at your other injuries, OK? But only after you’re dressed.”
She nodded. I had never seen Sugar cry, and something about it was more heartrending than anything I had experienced with her before. This incredibly strong girl, I thought, this strong girl.
A few minutes later, after Jan had examined her and taken some cultures, we talked in private. Jan’s face was sad but calm. I was suddenly so glad to have Jan here on this particular day, with all her experience and wisdom.
“There was vaginal and rectal tearing. It was a violent rape. He hurt her. He was
trying
to hurt her. But she refuses to let us call the police.”
“Why?”
“She says they won’t believe her.”
The idea was appalling. “Do you think that’s true?”
“She said they’d say there is no such thing as raping a prostitute.”
“But she didn’t ask to be a prostitute.”
“Maybe that’s not how they would see it. I don’t know. That’s not how she sees it. This is a girl with extremely low self-esteem,” Jan said. “Whatever happens to her she thinks she deserves it. Plus, she’s eighteen. We have to respect her choice.”
“Amy said something like that once too,” I said.
“Well, maybe it’s time you listened,” Jan said. Her smile wobbled a little around the edges. I could tell the exam had gotten to her. I thanked her and went back to the exam room.
I wished there were a way Sugar could be taught to love herself. I wished there were a way she could see that she deserved better. Jan had given her a box of apple juice. She was carefully sipping from the straw. I put on fresh gloves and began checking her facial injuries. There were a lot of small cuts.
“Was he wearing a ring?” I asked, looking at the inside of her mouth.
“Wedding ring,” she mumbled.
“Your teeth look OK. No eye damage.” I finished the exam. “It should all heal.” At least the outside, I thought.
“I should have known better,” she whispered. “A white guy in a van.”
“Don’t blame yourself. Blame him.”
“Stupid.”
“If you report this to the police, you can save another girl from going through the same thing.” I felt as if everything I was saying were falling on deaf ears.
“It’s all the same.”
“It’s not,” I said.
I saw her becoming resistant and defensive. I was not going to badger her, especially not now.
“I’m going to give you a shot of Rocephin, a dose of Zithromax, and a dose of metronidazole,” I told her. “Those are in case you were exposed to anything. We’ll be testing for hepatitis, HIV, syphilis, chlamydia, and gonorrhea. I’m going to assume there was no condom.”
She wiped a stray tear. “No.”
After she had left, I went and sat down up front. I rubbed my face with my hands, smelling the powder smell the gloves had left. Jan came and joined me. I was glad there were no other patients for the moment. “Of all the days for you to be here, Jan, well, I’m glad,” I said.
“I’ve been nursing for a long time,” Jan said after a long pause. “I’ve seen a lot of rapes.”
I looked at my hands. “I feel like I’m going to dream about bruises. Why won’t she see a counselor?”
“You have to give it time,” Jan said softly.
“What do you mean?”
Her eyes were distant. “Sometimes it takes a few months. Then the symptoms start: the nightmares, the flashbacks, and the insomnia. That’s when she might be ready for help.”
“I’m not sure I understand.”
“Understanding rape is part of our job, Randy. Please try to recognize why a woman would want to try to forget it.”
“OK.”
“This is hard work, Randy. Make sure you take care of yourself.” She paused. “Let other people take care of you too.”
I knew Jan was right. More than two years had passed since we started the van, and I had spent all my time trying to help others all by myself. I left out my own wife far too often, and in trying to do everything maybe I wasn’t doing it right at all. But it was easier to recognize this than to change it.
At home that night I took Ginger for a long walk. Soon we had covered over two miles. I was cutting through an extremely wealthy neighborhood where houses were hidden behind high walls. The sun was setting. I thought about how some people might feel frustration with Sugar. Why wouldn’t she go to the cops? they would ask. I didn’t feel that frustration. Instead I felt a huge burden. Here was a child who had been neglected her whole life, raped into prostitution, and then left to make decisions all by herself. Of course they were not the right decisions. But they were her decisions. I had to support them.
I knew as a doctor that people made self-destructive choices. They ate too much even when they had serious complications from obesity. They kept smoking when they knew they could die of cancer. They didn’t exercise or eat right or take their medications. I had seen adults die because they refused to take simple steps to save their own lives. Even some doctors, like me, were guilty. I ate too much junk food and didn’t sleep enough. That Sugar had survived this long was like surviving a game of Russian roulette with HIV and violence.
I thought that for Sugar even to come to our van was an act of
courage. For some kids that alone was a huge step. Someplace inside her there was a voice that was telling her that she did deserve help. Someplace inside her was a fighter who had decided that even for just a few minutes she deserved care. I felt hope entwining with darker emotions. Sugar had a chance. I didn’t care how slim it was. I was going to fight for that chance. If it took years, I would keep trying to save her.
When I walked back in, both the twins were crying. They were now almost a year old and getting into everything. Time seemed to be flying by. There were times I still veered around the oxygen tank in the living room, but it was long gone. Amy handed me one of the twins as soon as I came in. I knew instantly from the weight in my arms it was Janie. “You were right, Amy,” I said.
“Right? About what?” Amy held Reed while she pulled forks out of the drawer. I noticed how gangly he was getting. He kicked his legs in dismay. He wanted down, so Amy put him on the kitchen floor. There was a delighted look of freedom on his face, as if he had just discovered the magical world of drawers and knives and electric sockets.
“Reed!” I said as he reached for the stove. It was way too high, but still, I worried. He grinned at me, his new teeth coming in. Janie babbled in twin sympathy to him. Our dad, she was saying, is a mean old man.
Amy was saying something over the din of my thoughts.
“What was that?” I asked again. “What?”
“I’m pregnant again,” Amy said, stepping toward me. I froze. “Pregnant.”
I felt the same wave of excitement I had felt before. Only this time it was tempered with more notes of caution. The miscarriage; the endless months in the hospital; the exhausting nights spent feeding preemies: it all came back to me.
We both had wanted large families and from the early days of our marriage had made plans to have many children. Four or five or even more kids were what we had dreamed. In those early talks we had never considered we might have a problem with pregnancies. Amy was so healthy; why would we think there would be a
problem? I knew it was so important to her to have children that she would try again and again. I saw how happy Amy was, and I was happy too. But I didn’t see the same worries in her eyes that I felt in my heart.
In only a few weeks we were back in the hospital for an early ultrasound, receiving the brutally familiar news, a cruel déjà vu. I felt as if I had stepped into a time tunnel. Waves crashed in my ears. Once more our baby was dead.
“There is no heartbeat,” said the doctor. How could this happen again? We had told each other the first miscarriage was random. We had told each other that Amy’s illness with the twins was bad luck. But a pattern was emerging. Our efforts to have babies seemed to come with terrible risks. Amy and I touched hands. Her face was calm.
“We have two options,” the doctor told us. “We can do a D and C right now to remove the dead tissue.” I envisioned our dead child being taken from Amy’s womb. I knew how Amy would react to this. “Or we can wait a week or two. The chances are your body will expel the dead tissue.” Like last time, I thought.
I remembered waking to the sound of Amy crying in our bed. We would have to go through that again. I wasn’t sure I could do it.
“We’ll wait,” Amy said.
I had expected the miscarriage to happen quickly, like the last time. I thought it might be that night or the next day, maybe a few days at most. But weeks passed. Amy became quieter. I thought it was a mistake to have waited. She was walking around with a dead baby inside her. Still, she went to work. Her own practice was in a small family clinic. I wondered how she felt, holding those babies in her hands while we waited for ours to leave. Both of us had immersed ourselves in the lives of children, at home and at work.
As the weeks passed, we both went back to work, with Amy caring
for the twins as well. She had made an appointment with her doctor to get the D & C. She was on a part-time schedule and was able to arrange her hours around day care.
I took the van out by myself. Jan was off for the day. I had parked in outer Phoenix. It was a fine, sunny day, and the blue sky seemed to stretch forever without a single cloud.
A Phoenix police car pulled up in the dusty lot. The kids waiting under the awning fell silent. A young police officer jumped out. He looked to be of Native American descent, with bronzed skin and shiny black hair cut into a military crew cut. He opened the back door of his car. The teenage boy who got out was what we call in medical terminology
cachectic
, or extremely emaciated. His hipbones jutted out of his jeans. Skin was stretched tautly over his cheekbones and jaw. I could see the shadow of his teeth through the thin membrane of his skin. He looked like the survivor of a death march. If I’d had to estimate his fat percentages, I’d have guessed in the single digits. He had lost much of his muscle mass as well. Right away I thought he must have a terminal illness or be anorexic. Rarely had I seen such emaciation, even among addicts.