Ask Me Why I Hurt (39 page)

I got up and dressed. The face that greeted me in the mirror was forty-three. I thought: Remember when you were thirty-three, starting the van? When you couldn’t imagine doing this job for even five years? There were lines worn into my forehead. My once-thick brown hair was mostly gone, and I sported a short, tight haircut, a dramatic change from my younger years, when I wore my hair long. I no longer looked like the bright-eyed young doctor who had marched with determination into his boss’s office to say he should be the one to run a brand-new mobile medical clinic. That doctor had been full of passion and zest and sometimes anger. This doctor was a little travel worn, with more humility and an invaluable library of experiences to draw upon.

The cargo pants had been replaced by more serious trousers, the codebooks by a BlackBerry. If I accidentally left it at home, I didn’t panic the same way, though I did panic a bit. My attire had become more professional. I wanted to look more serious. It helped the kids understand that I could be trusted to help them. This was something I had learned from Jan: to be comfortable being in charge, because the kids needed that.

Amy, Reed, Janie, and Charlotte tumbled from bed. The tiny smile lines around my wife’s mouth gave her grace. She was certainly aging better than I. She barely looked any different now from when we had first met fifteen years before. If anything, Amy at forty-two looked more beautiful than ever.

Reed and Janie were eight now, and Charlotte was six. They brushed their own teeth, chattering quietly in the bathroom. I felt a tug in my heart at how quickly their childhoods were passing. Reed and I had just taken a father-son dune buggying trip out into the nearby mountains. We had gone fishing at Rose Canyon
Lake at Mount Lemmon. He caught his first fish, a rainbow trout.

Ginger came wagging into the bedroom. She’d been shaved for the coming summer season, and her soft underbelly fur was much lighter than her head and fluffy tail, giving her a Creamsicle look. There was gray in her muzzle, and her brown eyes were somewhat opaque. Recently she had started losing her hair and had developed one health problem after another. She was getting to be an old dog.

I emerged from the house to a fresh morning. In our driveway was my new hobby, an old Toyota MR2, just like the one my friend Danny and I had dreamed about. I claimed it just needed a lot of work, while Amy had slightly less polite things to say about my rusting heap. The kids called it Daddy’s race car, giving Amy endless amusement. I had realized I needed to have a bit of fun and stress relief—or comic relief perhaps—in my life. Working on the car with the kids brought back memories of my own childhood, under the hood with my father. I didn’t care if it ever ran.

In my same old truck, I drove to UMOM for the breakfast meeting. It was more of a celebration actually, to welcome new volunteers. Our whole team would be there. Thanks to grants and the support of the community, I had recently been able to hire several new people to supplement the core group. I finally had the solid team I had wanted. The days of having to take the van out alone or with just one or two helpers were over.

Jan was at the door of the conference room as I arrived. Nearby were nurses Julie Watson and Kim Williams, wearing bright yellow scrubs bearing the Crews’n Healthmobile logo. Nora Thibeault, the case manager, and Reece Tovar, the financial specialist, sat together at the far end. Rounding out the crew was Dr. Cody Conklin, our newest addition. No one had been more surprised or pleased than I when the award of funds from the American Idol Gives Back program fulfilled my dream of hiring another doctor for the van. When Dr. Conklin wasn’t on the van, she was out riding her horse. I noticed that she was still wearing her riding boots this morning. There was hay on the soles.

In addition to welcoming new volunteers, I was honoring an old one. Up front, I explained to everyone assembling, “Today we are honoring a volunteer who started a few years back as a college student. In part because of his work and dedication to homeless kids, he was just accepted into Tufts Medical School. We know he is going on to be a fine doctor. Alex, will you stand up?”

The room broke into loud applause, as his young face slightly pink, Alex stood up. Then he came up to accept a token of the team’s appreciation: a brand-new stethoscope engraved with his name.

I watched the faces of the team and the volunteers, glowing with enthusiasm and a sense of purpose. Over the last ten years, so much had changed. When I started, the concept of universal health care wasn’t even on the table. Back then most people didn’t seem aware of the devastating effects that a lack of insurance had on the poor, especially homeless children. Now that seemed to be changing, and I was hopeful that someday soon everyone would have easier access to medical care.

The kids certainly deserved it. It wasn’t acceptable for them to be forgotten. They were survivors. They were funny, kind, talented, and creative, and they desperately wanted to have happy futures. The societal response had been to ignore them, or put them in jail, or condemn them to marginal lives on the fringes. But after ten years on the van, I felt more strongly than ever that the prevailing treatment of homeless children in the United States was morally wrong. These were children who could be saved. They
deserved
to be saved.

The future of the country, I thought, depends on the next generation, yet I worried that we are failing our children. As the economy had worsened, more kids were hitting the streets. The high rates of depression, suicidal thinking, and anxiety I had been seeing were skyrocketing. The kids weren’t being prepared for adulthood, weren’t getting the tools and opportunities necessary for successful lives. Instead of jobs and stable families, they got violent video games and reality shows. Girls were taught to
care more about their bodies than their minds. Boys were given the weapons to express anger, not the nourishment of character to grow into men.

Children were the same everywhere, I thought. The kids I saw in Arizona were not fundamentally different from the ones in New York or Miami or Louisiana. In many ways the children across our country who were not getting adequate medical care were living in conditions similar to those in an underdeveloped nation. Society didn’t want to admit that, but it was true. We are such a rich country, I thought, with so many caring people. It hurts me to think that we let this happen. As much as I loved my country, and as much as I thanked it for all the gifts it had given my family, I still believed we all shared the responsibility for taking care of our children. It was imperative that we ensure their access to medical care and mental health treatment and dental care. It had been talked about enough; now it was time for action.

If I had learned anything on the van, it was to listen to kids. They hungered for adults who truly cared and could offer advice and assistance as they navigated this often frightening new world. And they needed to see role models, to see the adults in their lives helping the homeless, or bringing meals to the elderly, or simply being good neighbors. When adults showed they cared, they strengthened their families and their communities and neighborhoods, and they showed children that life could be lived with passion and hope. I thought about my own kids. Before I knew it, they would be teenagers themselves, growing up, and finding passions in life. I hoped I could inspire them to help others too.

“Randy?” It was Michelle, leaning over my shoulder and interrupting my thoughts. “Don’t forget you have that important phone call.” She tapped her watch. Michelle had taken over our program director activities from Jan and now controlled my schedule.

“That’s right, thanks,” I said. I was startled to see it was almost 11:00 A.M. I walked outside, waiting for the call.

My cell rang right when I had expected. It was a nurse-practitioner from the Midwest. She had been working for a hospital that
was seriously considering expanding into the community. The area was on economic hard times, and they knew there were many in the community who needed help. So her hospital board had asked her to research a mobile medical unit and then write a proposal. “I did a quick Google search and there you were,” she said. “I’ll be frank and tell you I know nothing about mobile health care.” That sounds like me when I started, I thought. I began taking her through the process. The costs shocked her. “There’s gas, insurance, huge maintenance bills, and honestly it combines with the higher overheard of running a small practice,” I said. “But a van does have the one advantage that makes it worthwhile. You can take the care where it is needed. There is no other practice that allows you to pick up and drive to where the patients need you.”

I spent the next hour pacing outside our offices, taking her on a step-by-step journey through the process of creating a mobile health unit. As we finished, I offered to share with her much of our initial research on the rules and regulations, so she wouldn’t have to reinvent the wheel. I wished her luck.

When I returned to the conference room, the table was cleaned and the trash can was overflowing with paper plates. Our offices were nearly empty, meaning the team would be waiting for me on the van, parked outside.

My positive feelings kept me buoyed throughout the afternoon, as I treated a long line of kids. I made sure I stopped for a quick snack of string cheese and an apple. I recognized that nowadays I was happier. It was because of talking to Amy. On the eve of the van’s anniversary so many things had been on my mind, and Amy helped me sort them out. Among them was my need to trim my schedule. If I wanted to be the right kind of father and husband, I had told Amy, I had to cut back on all the extras.

So Amy and I had agreed I would train someone to take over my job at the diabetes camp. I had also decided to no longer take the tests to remain certified in adult medicine. From now on it was going to be pediatrics only. But the decision that shocked some other doctors was that I was going to quit “rounding,” or visiting hospital patients. For a doctor such rounds were considered important
in maintaining a staff position. But I thought I should free my time for what mattered more, which was my family and the van.

My job was now just seeing patients on the Big Blue. What I was giving up in additional job security I was gaining in peace of mind. I knew now exactly what was important to me.

“Everything will work out,” Amy had reassured me during one of our marathon talks, when I had worried over finances and the future.

“You always say that,” I said.

“As long as we talk,” she said.

“We will, always,” I told her.

I had help now too. I thought about a recent incident on the van. Dr. Cody was on the van while I was attending to administrative duties at the hospital. She called me in a panic. An extremely sick kid had shown up. She had flown into action, taking a blood oxygen reading. His oxygen stats were dangerously low. She had already called the ambulance, she said, and he was now in emergency care. I told her she had done exactly the right thing. It had hit me later how I was now training other people to carry on the same work. Much of being a healer, I realized now, was not just taking care of patients, but training and encouraging others to do the same.

The afternoon passed quickly, and soon enough I was on my way home. It had been a good day, I thought. A good anniversary. The clock on the dash said it was 6:20 P.M. I had the entire evening free. I could have supper with Amy and the kids, walk the dog, and then help with bathing and bedtime with the kids. There would be time for Amy and me to sit around after the kids were asleep. We could talk, maybe, or watch a movie.

But first, I thought, I’d stop at the ice-cream parlor and pick up some peppermint ice cream for Amy.

1. Spend time with your children. Play their video games with them, listen to their music, listen to their stories.
   
2. Volunteer in your communities. Get involved. Vote.
   
3. Donate to worthy organizations if you have the means. Here are a few agencies that are mentioned in this story, or are close to my heart:
   

   www.crewsnhealthmobile.com
   

   www.childrenshealthfund.org
   

   www.umom.org
   

   www.diabetes.org/adacampazda
   

N
ow writing these final words, I feel a sense of accomplishment. But any achievements or goals that have been reached are directly related to the support, advice, and guidance from my family, friends, and mentors. I want to take the opportunity to graciously thank them for helping me along this journey. To my childhood friends, Danny Cennter, Kim Briamonte, and Greg Davis: you started me out on the path to success. To my high-school friends Tim Sellers, Rob Walsh, and Jeff Thomasson, you made the high-school job meaningful and fun. My college friends and fraternity brothers Glen Mandigo, Jay Ferguson, Mark McLear, John Muehrcke, and Joel Rapp gave me memories to last a lifetime. In addition I want to give a special thanks to Marshall Brennan, who often listened to my ramblings as I tried to piece together the stories and to Ron Couturier, who is the godfather to my children, and that should say enough.

To my medical-school classmates Melissa Smith, Holly Gallivan, and Kimberly Barrie, you made that chaotic time enjoyable. For my colleagues and peers Donna Holland, Sarah Beaumont, Michelle Huddleston, and Jeffrey Weiss, you all set the bar so high for yourselves that I become a better doctor just being around you. To Darlene Newsom at UMOM, thanks for helping out the program when we had no place to go. To my mentors Dr. Jack Copeland and Dr. Irwin Redlener, you both are my heroes and I hope you know how much better the world is just because you cared. The leaders at Phoenix Children’s Hospital, CEO Bob Meyer and senior Vice President Steve Schnall, showed me what it meant to
truly believe in caring for the community. To Nathaniel Jacks and Richard Pine, my agents at Inkwell Mangement, thanks for believing in the power of these stories. You have never waivered in your commitment to telling the world about homeless children. This story could not have happened without Jenna Ciongoli, my editor at Broadway Books, whose suggestions and comments took the story to the next level. To Rene Denfeld, you were able to able to take my jumbled thoughts and put them to paper with such visual intensity that every time I read the story I am living it. And for my team on the Crews’n Healthmobile, you are the reason for the success of this program. I applaud your dedication and commitment. Each and every one of you has been an asset to our program, and it could not have happened without you: Jan Putnam, Michelle Ray, Wendy Speck, Cody Conklin, Julie Watson, Kim Williams, Reece Tovar, and Nora Thibeault. Lastly I thank my wonderful family, who supported me and picked me up when I thought I couldn’t get up any more. Mom, I love you. Dad, I am so proud to be your son. Stephanie, Curtis, Matthew, and Trevor, you all mean so much to me. Amy, you are everything I need and all that I want. You make me a better person every day I am with you. Janie, Reed, and Charlotte: one day you will grow up and read this book. I hope it helps you understand how much I love you, and why it hurts so much to be away from you.