Tuesday, September 23, 2014

you can't give hugs in jail

First, some background: 
The LA County Jail is the largest jail system in the country (and possibly the world)It is made of up 9 different facilities that house 15,000-20,000 inmates at any given point in time. 

Men's Central Jail is one of these 9 facilities. It can house up to 5,000 inmates. It is located on the northeast edge of downtown Los Angeles. Five percent of the inmates in Men's Central Jail have known HIV. I work there 2 days each week providing HIV care.
To enter the jail wards, you have to go through a sallyport (aka cage) - where you enter through one gate, which closes behind you, then wait until the second gate opens into the ward. It's a little intimidating. 

I was given a couple pieces of advice for working in jail:
1. Wear pants. (Pants as opposed to my usual dresses. Not pants as opposed to nothing.)
2. If you get lost inside, don't wander. Just fall to the ground and start shaking. A security camera will eventually see you and send help. (I have yet to need this.)

One of my first patients was a young man who recently moved to LA (as always, details changed to protect privacy). He found out he had HIV a while ago but hadn't seen a doctor yet. Despite violence in his family growing up, he'd come far in life. He was credits away from bachelor's degree and had plans to open his own company. He was well-educated about HIV and what it meant when someone had progressed to AIDS. But that knowledge didn't prepare him for the fact that his infection had gone that far. So this beautiful boy, who I'd already invaded with personal questions and now broke crushing news to, started to cry. Because he hasn't lived a quarter of a century and already has AIDS. Because whatever hope led him to LA has been derailed by incarceration. Because his momma sits across the country and has no idea her son is in jail or that he has been living with HIV. 

In any other setting, I'd reach out and touch him - place a hand on his arm or pat his shoulder or offer a hug. But you can't give hugs in jail. So I willed my eyes to speak what I couldn't communicate with touch so he would know he is not alone. Over and over, I reassured him: this is not the end. things can get better. you can get better. 

He was released the next day. He knows where to find the clinic where I work. I hope he comes. I owe him a hug.  

Friday, September 12, 2014

taking in stories

It's crazy to think it's been more than a month already. There is a lot of HIV in LA. I have spent a lot of time listening. I have taken in a lot of stories.
(billboard on my drive home each day)

The stories start to run together. It's not that they are the same - it's just that there are so many:

A woman who was diagnosed while she was pregnant. She told her oldest child but still doesn't know how to tell the young ones. 

A father who didn't want to spread his cough to his baby girl, so he came to the ER to get checked. Now he asks if it's safe to hug her ever again. (yes, it is.)

A woman who was raped while she was crossing the border. Her child and family are still in Central America; she hasn't told them what happened. 

A grandmother who needed a blood transfusion years ago. 
A traveler from Europe who felt sick during his vacation.
A rapper with big dreams who ended up homeless and addicted to drugs.

People who have fought HIV for years, and people who found out only minutes ago. 
People in good relationships and bad ones. 
People who sleep on the streets and people who live in mansions.
People who laugh and cry and fight for life with a resilience I'll never know. 
A lot of the time, the sorrow of these stories is overwhelming. And despite huge advances in medicine, having HIV is difficult - whether it is the hurt or shame of how it was acquired, or the discrimination that those with HIV still face, or isolation from family, or struggling to break free from the addiction that led to becoming infected, or being unable to work due to illness, or simply having to remember to take medicine every day from now on. I'm still figuring out how to take it all in, how to keep listening, how to keep offering hope. 

"Compassion asks us to go where it hurts, 
to enter into the places of pain, 
to share in brokenness, fear, confusion, and anguish." 
-Henri Nouwen