Coming Home
The patient is dishevelled. Her hair is nappy, pressed down on one side and bulging out on the other. She is screaming from atop a gurney and I ask her to stop. She tells me that all she wants is to go home. I say, fine, I’ll get her home as soon as possible, but I need her to her to calm down and to stop screaming. There are other children in the room and she is scaring them. She tells me that she doesn’t give a fuck.
I am working the Metropolitan Hospital Paediatric Emergency Room in Harlem where I have worked since 2008. Though I am back in NYC for only ten days, it’s a good chance for me to reconnect and to be honest, to make a little extra money. My colleagues and the second and third year medical residents whom I train and know are glad to see me. It is great to catch up and I am happy to tell each person who chances upon me about my interim in Liberia, but I am also super conscientious about telling the same old story and overplaying the experience generally. We all have our work.
Any nostalgia or embarrassment of reunion is quickly tempered by the distressed female teen. The patient is seriously agitated and not coincidentally handcuffed at her ankles and at her wrists, which have been wrested uncomfortably behind her back. “Can we take the restraints off the patient?” I ask the officer who has come in with the paramedics and patient, “I can take it from here.”
“No we cannot,” the officer replies, “She is under arrest for assaulting a police officer. She broke my partner’s leg.”
“You broke a police officer’s leg?” I say turning to the patient, “that is pretty hard to do.”
“All I wanted to do was wear my hat,” she explains. By this time she is crying, “and then the teacher calls the police and then they tackle me. It’s not fair. I want to go home. I was protecting myself. I want to be with my Mom.”
We bring the patient into the trauma room to give her some privacy. With time I convince her to submit to a basic physical exam to “clear her”, but twenty minutes later, instead of facilitating a quick discharge home, I have cleared the patient to be held in the hospital psychiatric holding pen to be further assessed by a “mental health professional”. The patient will not be returning home anytime soon. Four hours is my experience, that is, if she is not held on the fourteenth floor for a two to three day observation.
I had tried to do steer the outcome differently. Every medical person has been trained in psychiatry and I have never regarded the practice as particularly difficult: You listen. You look for pathological characteristics and behaviours. You try to come up with a solution that works for the person in the real world which often involves legal drugs. After questioning and speaking with the patient and her family, it was my conclusion that she was not a danger to herself or others and had a supportive family who could take care of her. Her predicament reminded me of two instances in my childhood: Twenty three years ago as a high school Senate President, repealing the school hat law. Eighteen years ago as an Oakland junior high teacher, my students explaining to me how they would die for respect. “What else do we have, Mr. Wang,” they said, “on the street there is nothing else.”
So, it kind of made sense to me that this teenage girl, this young adult, refused to give up her hat and was willing to fight tooth and nail to keep it on. But when I moved to discharge the patient to her mother who was coming in from work, I was informed by the head nurse that doing this would be a violation of hospital protocol. I was reminded that the paediatric emergency department could not take responsibility for this patient; that if there was even a remote chance that the girl returned home and became violent hurting herself or others, I would be exposing the department to unnecessary risk. “We will be sued,” the nurse said.
By this time, the patient light board was fully lit and three residents were waiting to present to me their patients. “Okay,” I said, “Bring her to psychiatry down the hall.” I felt deflated like a flat basketball on a dirt floor. The patient as she was being wheeled away gave me a look of betrayal. It was worse than her saying anything. Working this shift in Harlem was intended to rejuvenate me but instead I am reminded of the parts of the System and myself that made me leave.
* * *
It is a week later and I am walking to Metropolitan for my second and final hospital shift before Seongeun and return to Liberia. I have stayed the night with dear friends in Westchester, which means the train drops me on 125th street, twenty-seven blocks away, but I am early and the weather is warm. It has been a year since I have ambled this stretch of East Harlem and I am curious about what has remained. Lexington Ave is its usual bustle of activity, but today in the bright each person, sign, window, brick, sound, roar, and hobble, appears like paints on a living palette—distinct, textured, and affected by the pigments next to it. As usual, there are only people of colour around: African-American, Puerto-Ricans, Mexicans, and Dominicans. As I walk I am aware that I am one of the few Asians who take this route and the eyes that notice, but I am also comfortable and don’t care as the people around me don’t care so long as I am comfortable. This particular balance in life of difference, I love.
My summer 2010 interns, Omar and Deepak
The sand blasting of the walls of the Harlem District Public Health Department on 116th Street where I worked for three and a half years is finally completed. The off-white brick looks better to me than expected, devoid of tarry grit, but workers remain at the main entrance fiddling with a new sign. I think that this unnecessary multi-million dollar public health renovation has taken far too long. It occurs to me to go into the office but it is getting late and I don’t like the melodrama of forced greetings, which would happen. My time at the Public Health Department was not wasted but certainly not pleasant. I found that I wasn’t comfortable with the Department ideology—do what is right so long as it doesn’t upset the extant power structure-- and thus the pace of change and I didn’t possess the politic to play nice and the patience to learn new tricks. The only people who liked me in the Department were the janitors and that was actually okay with me. Bad sign.
On 110th, I hide across the street (and take a few pictures) outside of the Asthma Center where I was once the medical director. The front door is still broken and thus propped open. The Center which was built as a community-gathering place is as usual empty. I fell asleep during the movie Field of Dreams but the converse of its message was true. If you build a place that gives people what they want they will come. I take note that at least a well-stocked super-market with pretty fruit has appeared across the street. I remember the Center Director whom I still hate.
The lights of the Johnson Community Center are surprisingly on and I am naturally curious that the Center has finally opened. The Community Center had been finished for months while I was at the Department of Health but for financial and political reasons would not open for another sixteen months. It was in the context of the Community Center where I worked with the Johnson Residents’ Association on a large environmental clean-up grant that we didn’t get, on a hip-hop dance program for teens that is now two years old, and on a Friday night family movie night which played outside the Community Center once we discovered that we would not be using the inside for an indeterminate amount of time.
Inside community center overlooking gym
I don’t get even a few steps into the Center when I am recognized. First, by Marion, then by the women whose name I can’t remember who likes to kiss me on the lips, then by Eve, Ethel’s mother, and Maria. They are really surprised and so am I.
“What you finally decided to open this place,” I say, “Not shabby indeed!”
We exchange kisses and hugs and I ask for a tour. We move as an entourage and these fifty to sixty year old matriarchs excitedly but also as a matter of fact point out features of the facility which includes a place for seniors, a computer room, work-out facility, beautiful basketball court, community kitchen, dance floor, pristine tiled bathrooms with showers, open and closed meeting spaces, eating hall and more. The Center was the their idea, which took over seven years and sixteen million dollars to build and it is beautiful. I like how this place is very out of place in Harlem for its size, how modern it is and potential.
I am peppered with questions. Did I get married? When am I coming back? Where did I go? Do I like Africa or was it Asia? What is the food like? I am told that movie night still continues. We are missed. The head of the Center was fired—not a good man. Ethel will be mad that she missed me. The kids come in at two o’clock. What Asthma Center? I say that no one will ever use the showers. You women have not changed. I am so glad the Community Center is open. I miss being here. The kitchen is too small for cooking classes. The dance room needs mirrors.
Setting up of movie screen with painter's cloth
When it is time to go, we say our goodbyes as if greeting. I know I will be back and for good or for bad, the residents of Johnson Homes will remain. Selfishly, we will see each other again. Since I am now late for work, I decide to cut across the courtyard common to the Community Center and Housing Project. There is new construction happening, so there is a narrow wooden walkway confined on its periphery by a chain link fence but the sun is out and the path appears deliberately lit. As I walk, I glance at the back of the Community Center and I am pleased to see tape marks still scarring the large black wall, which obviously has held many makeshift screens for Friday movie nights. Movie night was really fun. For a summer, when we were just beginning, it was Seongeun and my weekly date chaperoned by public health interns. We would all march into the courtyard at about six o’clock and the children would run to us, always asking the same questions: What movie are we playing? (Ah, not that one!) What snacks will be sold this week? (Too healthy!) Can we help? (Of course!).
Much had to be done. The speaker system, computer, projector and lines set up. The snacks prepared. The ice water jugs filled. The Harlem Public Health Department Banner displayed. The two-hundred foot extension cord run across the way, along the grass, up the wall and through the window of Apartment 2C. The movie screen made of painter drop cloth had to be put up straight and with care. It was really big so you had to climb up high to hang it. I thought many times while standing on the ladders edge on my tippy toes that someday someone or I would fall and what I might do to prevent this.
Boot leg projection of Karate Kid --- ha ya!
