Monday, July 7, 2014


*details changed for anonymity and. . sigh. . you know the deal.

"Do you believe in redemption?" she asked me.

"Yes," I answered.



My shoulders sagged with exhaustion with every detail of your story. You'd seen "someone else" at Grady who, of course, was conveniently no longer here. That person had "promised you" that they'd fill out your lengthy stack of disability forms. So that was your agenda when you came that day. To get this paperwork completed so that you could go on your not-so-merry way.

Wait. Not so fast.

For starters, you'd strolled right in and handed those papers to the resident doctor. No trace of an antalgic gait or slippery cognition to anchor such a title as "total disability." I scrolled through the scant documentation of your hospital encounters in the electronic medical record. I mean, yes, you did have your share of hard luck. Health problems, indeed, but not ones that necessarily deemed you unable to achieve gainful employment ever again.  And so. I would be honest.

But that wasn't what you wanted to hear.


Here we go. I guess now she got to go get some other doctor to come in here and give me the run around. This is some bullshit. Some total bullshit.

I guess she thinks since we both black she can smooth talk me or something. Looking me all in the eye like we both know some secret. But really, I ain't here for none of that shit. I'm all messed up. My back hurt and I can't do the work I used to do. I just can't.

If I don't get some kind of income to get me the fuck out of this shelter? I just don't know, man. I just don't.


"Tell me about your back."


"Your back. Can you tell me about it? Like when it started hurting and the story behind how you've been feeling?"

You seemed so shocked by that question. Almost appalled. So I just sat there with my eyes fixed on yours waiting. Waiting to hear what would make a man not even ten years older than me want to get permanent disability.

Even though I think I sort of knew already.


"My back got hurt from all my years of lifting heavy stuff. Over time it was just too much. And now that I'm older, nobody want to hire you if you can't stay on the job for a long time. A lot of these young guys and immigrant dudes is so hungry, man. They can work a good fifteen hours straight like it ain't shit. I can't do that. And that's always been my job."

I told her the truth. The black lady with the short hair that was sitting in front of me ice-grilling me like she Dr. Phil or Oprah or somebody. And really, it all seem like one of those bullshit questions you ask somebody when you already know what you gon' do anyway. Rhetorical, they call it. Yeah. That.

She thought I didn't know a rhetorical question when I heard one. But she was wrong.


"That sucks."

I said that because it was true. I mean, it did suck that a man like you who used to work manual labor could no longer hang with the competition. It also sucked that you were living in a homeless shelter which appeared to add urgency to your need for some sort of supplemental income. I hated that.

"You know? It does suck."

Your expression softened a tiny bit when you said that. I'd learned during some tough times in my own life that something as simple as an acknowledgement of the shittiness of a situation could bring comfort.

"I'm sorry." I paused for a second before saying more. "How long has this been going on?"

You thought for a few seconds, almost like someone under oath. Your answer was careful. "A while."

I nodded my head. "Um. Okay."

When I said that you mopped your face hard with your hand. I could see this mix of anger and frustration welling up inside of you and I quickly tried to assess whether it was something that could threaten my safety. I decided that it wasn't.

Although I sort of wasn't completely sure.


She seem nice but with a angle. Like she got my number and just waiting to dial it. I prefer the doctor to just come in like an asshole and start refusing everything from the start. At least I don't have to think so hard.

That clock on the wall is ticking hard. Maybe it isn't but all I can see is the fact that right now it's two something in the afternoon and I got to go back to that crowded ass shelter in the next few hours. A man was hollering in there all night yesterday. They have big roaches and little roaches in there and I'm still trying to decide what's worse. It's hard to tell who is just hard on their luck like me and who is effed up in the head. Like, somebody might start talking to you and you can't tell if they high, about to rob you, schizophrenic or just in a jam. It's too much. And I ain't used to all that.

I feel my blood starting to boil so I tried to wipe my hand over it to keep from punching this wall next to me. The doctor look scared like she think I'm gon' hurt her. But I wouldn't.

This wall next to me, on the other hand, is another story.


I stuck to my motto: "Everything I say about you outside of this room is what I say inside of this room." In this case, it was that I couldn't in good conscience say that you were disabled and unable to work permanently. Not based upon the information I had in front of me, your exam, or what you'd told me.

You reacted as I expected. Some complex mixture of anger, frustration and despair. You threw out expletives as you pounded your fist on the desk. You said you felt trapped. And like a caged animal.

And that part sucked, too. But I was too scared to say it.


"Where is your family? I mean. . . . do you have any who are aware of what's going on with you?"

She asked that shit like it was so simple. "Hello? Hey. It's me. The one who ruined your lives because I couldn't get my shit together. Uh huh. Yeah. I'm homeless. Can I come there? Great!"

Man, please.

She got this short hair cut that you can tell she got professionally cut by somebody. Lined up in the back and clipped close on the sides. The kind of thing you do when you have a job and house to go to. So I'm looking at her wondering do she have any idea what it's like to lay on a cot still like a statue with your eyes wide open because you don't want a big roach to crawl on you or a little one to crawl in your ear or in your bag. I know she don't. I can tell by that haircut that she don't.



It sucked that a lot of this--okay nearly all of it--was an issue of resources. Like, if you had a place to stay while you sorted a few things out, you could and likely would get some sort of job. I could tell.

You said things that suggested you were worldly and full of the wisdom of hard-fought lessons. I wanted to know. I wanted to know why you were too proud to turn to your family. Because when I asked if you had any, you never said no.

You didn't.


One of my daughters had two babies when she was still a teenager. But she raised those girls up and they both made it to college and they doing good. Granddaughters in college. Good colleges, too. And it wasn't too far of a stretch because in spite of me and the hell I put their mama through, both of my daughters went to four-year universities, too. Married with good families and situations. So I feel like I owe it to them to stay out of their way.

Their mama forgave me. Not in the way where you forget what happened. But she always told me that I was sick from the alcohol and that, since my daddy was the same way, a little piece of it wasn't my fault. She real happy in her life, too, so I think that gave her room to let go of that anger. Some part of that is what gave me the courage to do the same thing eight years ago.

Eight whole years now. And I got the Alcoholics Anonymous key chains to show for it.


Wait a minute. Eight years of sobriety? Eight years? And all you've done is exchange mundane text messages and front like everything is "all good" on the telephone with your daughters and granddaughters? The ones who, in your own words, were "very, very, very proud" of you for your recovery and who invited you to see your granddaughter graduate in the top ten from her high school right here in Atlanta?

"Why didn't you go to the graduation?" I asked.

"Because. They might find out I'm homeless. And I promised myself that I wouldn't be a burden."

"You don't think they'd want to know about what's going on?"

"It doesn't matter."

So I stopped talking there. Instead I just promised you that I'd get the social worker since we'd pretty much shelved the idea of permanent disability. And you seemed a little less upset when I said that and shrugged and said it was fine.

And that was that.


3:12 PM. Just a couple of hours before I have to go back to the little roaches and the big roaches and the screaming people and the maybe crooked ones.

Deep breath.

The social worker was nice. She told me some stuff I didn't know. And it turns out that my current medical issues do qualify me for some temporary help, too. She even knew about some places where you can get on your feet with working while you live there.

"Family?" she asked me.


Here we go again.


I popped back in after the social worker Mrs. Beasley had finished up. You were sitting there alone and, for the first time, you looked me square in the eye and smiled. I returned the gesture.

I took a chair right in front of you. Just as I parted my lips to speak, you spoke first.

"Thank you." That's all you said.

I felt my face get very hot, very fast and my eyes immediately starting to prickle with tears. I want to be kind. And I want to make people feel like they are significant. The look on your face, the tone of your voice just. . . .yeah.

"It has been an honor to meet you. Thank you for your honesty." It felt corny when I said it but it was true.

You reached into your pocket and pulled out your phone. Like the proud father and grandfather you are, you showed me a picture of a group of five young women, one of whom was wearing a cap and gown. "That's my grandbaby that just graduated," you said. "Heading up north to school. A good school, too."

"I know they are proud of you for your recovery. I just know it."

You nodded. "Now that is a true statement. They always send me messages on the milestones of my sobriety. Always, always."

"That's awesome." I decided to go there once more. "And you're sure you don't want to reach out to any of your family?"

You stared at me for a few seconds. Then you dropped your head into your hands and cried and cried.


I haven't cried in over ten years. I thought my tears had all dried up. But I guess they were just being stored up for this moment. It felt embarrassing but I couldn't hold it in anymore.

This kind, kind black lady doctor with her haircut and dry-cleaned coat didn't understand. The very best gift I ever gave my daughters was the day I left them alone. That's why I was crying. Because the best thing I ever did has always felt like the worst.

She asked me if I believed in redemption.

"Yes," I told her, "and I give it to my girls every single day that I stay at arm's length from their joy."


I have this bad habit of underestimating the enormity of how harsh a reality my patients face sometimes. With my Pollyanna view on the world, I suggest things like calling family or moving to the part of town where it's hard to get crack or applying for some kind of other job somewhere.


You started crying and it was clear. This was too big. Too big for me and my little bag of internal medicine tricks. But some part of me wasn't sure.

I tried to put myself first, in your shoes, and second, in your daughters' shoes. I tried and tried but couldn't really get my foot all the way inside enough to be objective. It kept playing like some ABC After School Special where everyone would hold hands and dance ring-around-the-roses as the credits rolled.

"I'm sorry if it seemed like I oversimplified this. I'm sorry."

"No. I appreciate you caring so much. I really do." You were still weepy a little and patting your eyes. All of it so complex and so riddled with regret.

"It is really your decision to make, sir. And not an easy one." I took a big drag of air and stood up. "I will be praying for you, okay?"

"You will? I'd appreciate that."

"Okay. Then I promise, I will." And I said that because it was true.

Perhaps some might think that's inappropriate to say but it felt right.


I didn't get any of the things I asked for when I arrived. But I somehow felt better anyway.

My phone rang as I was walking out of the clinic. One of the girls.

"Hey Dad. Just checking on you."

"Hey there. Just leaving a doctor's appointment."

"Is everything alright?"

I checked my watch once more. 4:01 PM. Plenty of time to make it back to the shelter without risk of being stuck outside for the night.

"Is everything alright? Yeah, baby. Your dad is cool. Cool as a fan."



Bless my patient indeed. Enlarge his territory. Let Your hand be with him and keep him from harm so that he will be free of pain. Please, God. Grant this request.

And Lord? Keep blessing those girls of his. And blessing their mama because mamas are important. And, I guess, just let Your will be done in this. 

Thanks so much for giving my patient sobriety. Please God. Give him his life back, too, so that he can be a blessing to somebody. 

And God? Bless me, too, so that I can keep doing this. Help me to sleep tonight. And to not be haunted by the unbalance of the world . . . or the sound of someone hollering in the cot next to my patient.


Happy Monday.

Jabez cried out to the God of Israel, "Oh, that you would bless me and enlarge my territory! Let your hand be with me, and keep me from harm so that I will be free from pain." And God granted his request.

~ 1 Chronicles 4:10

Now playing on my mental iPod. This, a song that I love to let minister to my soul. Playing this song for my patient today. . . and for myself, too. Even if if it sort of makes me cry.


  1. This is stunning and sobering. I find you to be not just an extraordinary doctor but human as well. I know it's difficult to do what you do, every single day, and stay connected and sane and true to your profession and to your humanity. But I think you do, and if you ever need assurance of that, I'm here to give it to you

    On another note, I posted on my own blog tonight about stress, about our difficulties as Americans asking for help, the pressure to be self-reliant, etc. While your exchange with this man is certainly an extreme version of it, I am struck by his resistance to asking for help from his family. I'm not wondering about it -- I totally and utterly understand it. And I don't know what to think about any of it -- other than to quietly acknowledge and observe and give it up to God -- the universe -- ask for help, even, in the thinking.

    1. Elizabeth, how serendipitous that you just wrote about this on your blog. I loved reading your words (as always) and it made my eyes even leakier thinking of my patient. And yes, I also don't know what to think of his decision. That said, the Pollyanna in me is rooting for him to ring one of his daughters' doorbells and realize he has a home afterall.

  2. What strikes me is this man is trying to make a way out of no way and he doesn't know how. He really thinks he's doing right by his family by not involving them, that is clear. I am glad you got him the social worker, and were able to see that he's not shiftless and a mooch on the system but a man who cannot see any options. You are such a fine human being, as Elizabeth says, in addition to being a fine doctor. I think by truly SEEING him, you helped him feel more worthy in his own skin. That, perhaps, can be the beginning of him being able to imagine a way out, maybe even by reconnecting with his family. I pray so.

  3. This was wonderful. I can "hear" both of you. I hope he reaches out to his daughter. As a child of a former substance abuser, I can't imagine not seeing him.

    1. Wow. That sort of makes me feel hopeful inside.

  4. This was hard to read. I don't know this patient. Truly don't know what is going on with him. But I get frustrated at people who are claiming disability that is at best questionable. I work 40 hours a week. I'd like to take on a weekend job, but spend most weekends sleeping off the week. I can't remember things. I often lose words. I have a computer list of words that I tend to lose. It's chemo brain. When I go in to a meeting the names of expected attendees are at the top of my notebook page. I forget the names of people whom I've worked with for 14 years. I can't lift anything above my shoulder. I can't lift much over 20 pounds. My gait is unsteady. I walk into walls. I keep exhaustive list of what I need to do next. Things fall off of that list. There is more, but I work 40 hours a week. Nothing compared to you I'm sure. When I hear "I can't work because my back hurts." I cringe because the radiation treatments means that my neck never stops hurting. I have very little feeling left in my fingers and toes, but I manage to type. I manage to separate pages because I must work. Still, I know people who fell down once and hit their head and can't work. I have dents in my skull where I have fainted and hit my head. I work. I can't imagine not working. My first job was at Cherokee Plaza where the Kroger is now. It was a theater then and I worked there from the time I was 12 to the time I was almost 14 and they found out I was under aged, I am eligible for retirement at my job. It's pretty generous. I have been told by more than one doctor that I am eligible for SSDI. I understand the desperation of your patient, but I know it is no sort of life. I so wish he'd given his family the chance of redemption. I have experienced more grace than I could ever imagine in this life. I'm sorry that he won't open himself up to that. Rejection is the strongest pain known to man, but redemption is the highest joy.

    I tend to be, you'd better be limping if you park in a handicap parking space. And yet understand that all disabilities aren't always viewable.

    Once upon a time family were responsible for family, no matter what the situation. Now it doesn't seem to work.

    I'm not judging your patient. I'm just frustrated by his kind.

    1. LIsa, he was a good guy. Just one living in a "first world" land but trying to tackle more than "first world" problems. He believed that avoiding his girls was his way of extending them grace. He also felt sure that their success was firmly rooted in that decision. "They aren't broken," he told me. "And I know that's because I released them from the burden of my addiction."

      I don't think this guy should be lumped into the slicksters trying to game the system. He was just desperate but not hard to get on board with reason. And "his kind" could be easily be "our kind" but for the grace we both know so well.


"Tell me something good. . . tell me that you like it, yeah." ~ Chaka Khan

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