Showing posts with label jail. Show all posts
Showing posts with label jail. Show all posts

Tuesday, July 19, 2016

on changing the world

I wanted to change the world. 
During undergrad, a group of my friends started cooking "downtown dinners" - a weekly collaboration of boiling excessive amounts of spaghetti and warming marinara sauce (or on fancier nights, making minestrone soup). We took the food to a courtyard in downtown Gainesville where those who were chronically homeless tended to congregate. The point of the evening was to talk to those who had come to eat. To hear their stories. To listen. 

Being there was hard. It is tough to take in the stories of how someone becomes homeless. It is tough to face the societal issues that underscore these stories: systemic racism, unequal education, untreated mental illness, substance use, trauma. Each week these stories would come out - sometimes cohesively, sometimes shaped by paranoia, loose associations, and angry outbursts. We would listen.  

I don't think any of us were under the illusion that we were making a difference. After three years of these dinners, little changed in the lives of those we sat beside each week. Miss Mary and her collection of mangy dogs still lived in a decrepit tiny house without running water or electricity. Ed kept pushing his shopping cart full of garbage, telling anyone who listened about his mother who had been stolen.* Even though we knew we weren't changing anything, we still showed up each week with pasta in hand. 

A decade later, I found myself working on Skid Row** in Los Angeles during my HIV fellowship. For a year, I took care of the sickest and poorest people in this country.  Most were not housed; for those fortunate enough to be sleeping under a roof, that housing was generally not stable.  For a year, I followed a panel of patients for whom HIV was negligible in comparison to their daily battles for food and shelter and against addiction and mental illness. At the end of our year, my co-fellow and I reflected on our time there: for almost all our patients, little had changed.  A couple patients managed to secure housing. Many more had disappeared from care, lost in the throws of addiction or incarceration. One was murdered. Most are still in the same struggle simply to survive. But we were there. We fought for them to get the medical care they needed.  We listened to their stories. We let it shape our own. 

Now I work in the wealthiest county in America, where poverty and homelessness remain invisible behind the wealth that saturates the Silicon Valley.  Many of my patients are homeless, or will be once they are released from jail. I know that the thirty minute encounters I have with my patients are never going to be enough to undo the injustices in their lives. I can choose the best medicine and carefully explain their health conditions in terms they can understand. But the reality is they leave their visit with me and return to worlds I can't imagine.  Whatever love and compassion and patience I put into our encounter, it can't undo the crack their mother may have smoked while she was pregnant, or the multiple foster homes they were shuffled between, or the gang that was the first place they felt accepted, or the meth addiction that fuels cycles of incarceration, or the criminal charges that unfairly limit future employment and housing and the right to vote. 

There are millions of places of brokenness in this world, and as Sarah Kay so beautifully puts it: "No matter how wide you stretch your fingers, your hands will always be to small to catch all the pain you want to heal." 

I've stopped wanting to change the world. I still seek out the places that are broken, where injustice seems to have won. I still sit and listen and ask the questions whose answers will break my heart. But I don't go to change anyone, because I can't. I go because God is there. I go to love.  

I got a text this week: you saving the world today? 
Nope, never saving the world. Just trying to be love, and praying that in this world that has gone mad with violence and hate, that Love would be what saves us. 


*his mother had not, in fact, been stolen. We did track her down; she was living in a nursing home, trying to recover from the strain of years of caring for him and his profound schizophrenia. 
**yes, this is a real place. 

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.