Shotgun house. He lived with a prostitute in the front room of a shotgun house off Woodall-Rogers Freeway near downtown. (A shotgun house is a narrow one-story shack that could theoretically be cleared with one shotgun blast through the front door.) In the course of being treated for cancer he suffered a radiation injury that caused triplegia, paralysis of both legs and one arm. The other arm wasn’t much good. When he came home from the hospital the woman put him on a bedpan and left him there for a day or two. When I got there the skin over his coccyx was intact, but was kind of purplish. Within a few days the skin began to change color and underlying tissue began to break down and soon there was a large (~10 inches in diameter) and growing decubitus ulcer (down to the bone). I would clean the ulcer and we would talk. He was bitter about what had happened with the cancer treatment as I recall, but he had been a hard life before the illness and injury and he was mostly accepting or resigned, or so it seemed to me.
From time to time when I was there, the woman would bring a trick through his room on the way to her room. She was a heavy drinker and often smelled of liquor. She was sweet-natured and pretty in her own way, and I liked her. Teaching her to care for him was a real challenge.
The ulcer got bigger and bigger and after a few months he died. A couple of years later I saw the woman on a corner in another part of town and stopped to talk with her. She was drunk and smelled pretty strong. She asked me if I wanted to have sex with her, but I said no thank you and gave her some money. That was the last time I saw her.
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Eggnog. He lived alone in the Cedar Springs projects. He had head and neck cancer (squamous cell carcinoma) with many tumors in the nodes of his neck and down into his chest. He had a mattress on his living room floor and he got around by crawling from one room to another. He had difficulty swallowing and was unable to take any solid food. He liked eggnog, which was fine around Christmas, but problematic after the holidays. I went to quite a few stores to find the last of the eggnog. After that he had to make do with protein drinks, which at the time were not as readily available as they are now.
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Burned. There had been a gas shortage and two brothers decided to hoard cans of gas to sell at a big profit. He lit a cigarette and the gas exploded, burning him over most of his body. After months in the Parkland burn unit he was finally discharged. He didn’t do his exercises and ended up with his arms frozen in a flexed position. He had no fingers, no nose, no ears – every part of his body that protruded had been burned off. He was pretty much all scar tissue.
He lived alone the same Cedar Springs projects as the man with head and neck cancer. His wife would come over sometimes and would throw his meals-on-wheels food on the floor. When he walked he would stagger; when he went out the children in the projects would throw things at him and call him names.
I don’t know what happened to him.
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A prayer. The promotora de salud (lay health promoter) and I went to see a woman with far-advanced cancer. She was in a coma and had gangrene. She lived in one of those barren outlying Oak Cliff pink brick apartment buildings where gangs pretty much ruled. The main thing we were there for was for the promotora to pray for the patient. We were there at her bedside – the patient and her daughter, the promotora, and me, all holding hands. Everything was in Spanish, except when the promotora leaned over to me and whispered, “I think her toe just fell off.” It had.
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Dressing change. There was a homeless man who hung around on Bryan Street. One of his legs had an old injury that was chronically infected. The lower part of the leg was markedly enlarged and hard and suppurating. He refused to go to Parkland, the county hospital.
At the time, my students and I were operating out of the “police storefront” at the corner of Bryan and Annex. The police had banned the homeless man from coming inside after he had used their toilet to have a huge and hugely malodorous bowel movement.
He would come to the storefront every week and one of the students or I would change the dressing on that leg. It was literally a weekly dressing change that involved cutting away the old exudate and blood-soaked dressing and putting on a new dressing. He would sit on the bench of the picnic table or a retaining wall outside the storefront for someone to change the dressing. I thought the maggots might be what was keeping him alive. I was surprised at how fast maggots can move.
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Staying home. Ms. Brown lived in a sparse one-bedroom apartment with Mr. Escalera. She had rheumatoid arthritis, was home-bound, and in fact, mostly bed-bound. I recall that the first time the students and I turned her over a multitude of cockroaches scattered out from under her back. She had several health problems, especially the pain from RA. She was a nice woman with a good spirit and was very strong mentally. While the students were in the bedroom with Ms. Brown, Mr. Escalera and I would sit at their little kitchen table, talking and him smoking. I marveled at how he was able to keep her at home – get her to the bathroom, take care of food, clean the apartment, everything. After a few years there were changes made in where and how the students and I were operating, and we quit seeing Ms. Brown. Ultimately, she developed cancer. She never told anyone and she just wasted away in her bed. I saw her a few times during the course of the illness, but she refused any assistance other than the home visits. My friend, Alison, the missionary also became involved. We all did exactly what Ms. Brown wanted, which was to help her never leave her home in her little apartment.
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The students. When I refer to “the students” I mean the Baylor students who were in my community health clinical groups. Each semester I had two groups of eight students. Very few of them had ever been exposed to the levels of poverty and unmet health needs they were immersed in through this work in refugee communities. They worked with me as partners in learning about community health through providing community health services. The students operated in two-person teams in designated neighborhoods. They learned about community health through finding people with problems and alongside the patients, solving the problems – and never just referring people to somewhere else.
As much as possible, they went through “the healthcare system” with patients; students learning, for example what the Parkland OB clinics are like: a waiting room with 50-100 plastic chairs; waiting room floor sticky with spilled soft drinks and baby formula, Cheetos, whatever; maybe 16 exam rooms around the waiting room (my memory is clouded re some details); someone shouting/mispronouncing patient names (you better not miss hearing your name called); and once in the exam room, being seen by a different person on every appointment (expect another vaginal exam); being sent out from exam not having any idea what next.
Eventually, as we developed the Agape Clinic (a-ga-pe) as a community resource, the students spent more and more time in the clinic, though we never abandoned the home visits and community outreach. In the clinic students had responsibilities that rotated week to week – triage, manager, exam rooms (5), pharmacy. As was the case with the outreach/home visits/district health model, students had significant responsibility and autonomy. Oh, what a job they did!
Here is a description of the work, in the streets https://ckjournal.com/in-the-streets and more on the Agape Clinic https://ckjournal.com/agape-clinic-recollections
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On San Jacinto. In one of the apartment buildings in the 4000 block of San Jacinto there was a Vietnamese woman who had some unspecified mental health problems that were manifested in part by her yelling and sometimes fighting with neighbors. She had a dream one night that her apartment was filled with Buddhist and Catholic religious statues. She began putting religious statues in her apartment according to the dream and as the apartment was filled, she quit the yelling and fighting. She became something like a fortune-teller. Although she didn’t have any outstanding health needs, I would stop in at her apartment when I could. She would fix coffee for the two of us and we would sit at her kitchen table and talk.
In the same building there was an old Vietnamese couple living with a teenage girl named Thuy who was deaf and mute. The man had a stroke. He survived but was completely incapacitated. By some miracle he ended up in a nursing home just a mile or so from the apartment. His wife would walk to the facility every day to bathe and feed him. When he died the funeral service was held in a South Dallas funeral home. I remember his wife and Thuy ended up on their knees on the floor in front of the coffin, wailing and falling out. After school Thuy went to work at Fiesta groceries and did well, as far as I could tell.
In the same building there was a Cambodian woman who was married to a White man who was somehow involved in drugs. One day Leslie called me and said I should come to her office right away. When I got there the Cambodian woman was sitting under the conference table in Leslie’s office. She had appalling stitched lacerations on her body. Two men had come into the apartment and stabbed her husband to death, raped her, and slashed her. She had been taken to the ER and when they were done with her, a missionary named Chuck brought her to Leslie’s office. I went to her apartment to let the police know where she was. I remember how polite the homicide detective was when he questioned me (everyone is a suspect in their world). I remember that there was an amazing amount of blood on the bed, floor, walls, and even the ceiling.
In the same building there was a Lao family – three generations in a small apartment. They had pigeon cages covering several windows with the pigeons free to come and go to the outside world and a sliding door on the inside. At night whenever someone wanted they could open the sliding door and reach into the cage – pigeon for dinner. Eggs, too. The same family had a big aquarium filled with popcorn and big grubs eating the popcorn – grubs for dinner.
Across the street a widow with two sons lived in an upstairs apartment. One day the brothers were arguing over a bowl of rice. One of them stabbed the other, who fell out the window and died.
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Get-away. The students ran across a 16 year-old girl who was living with a man in his mother’s second-story apartment on Virginia Street. The girl wanted to leave, but the boyfriend and his mother wouldn’t let her. The students talked with the police, but they had already been in contact with the girl and she was uncooperative. Now, she said, she had to get out. The police wouldn’t help, so the students and I came up with a plan for the students to make a home visit and distract the mother. While that was happening in the living room, the girl was throwing her possessions (in three black plastic trash sacks) out the window to me waiting down below in my blue Toyota pick-up in the driveway between two apartment buildings. The girl then walked out of the room she shared with her boyfriend and followed by the students, walked out of the apartment to the alley where I was waiting. Away we all went to the police office. One of the police officers bought the girl a bus ticket to LA where she had family in Compton. She was back with the boyfriend in about a month.
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A man with a gun. In one of the apartments on Annex Street a Chinese woman from Vietnam ran a little store out of her apartment. People could buy soft drinks, snacks, and the like. One of her daughters had a large nevus (mole) on her face. The mother told her daughter the reason she had it was because in a previous life she had wasted her husband’s money. A dermatologist at Children’s Medical Center Girl decided it was appropriate to remove it surgically.
On the day of surgery I went to the apartment to drive the girl and her mother to CMC. The girl got in the truck first and said, “My mother says there’s a man with a gun in our building.” I said, “Tell her to get in the truck now.” The girl said, “There’s the man.” Sure enough a man was walking towards us and he had a pistol (like a .357) stuck in his jeans. I reached across the girl and pulled her mother into the truck and was backing up across chunks of concrete and curbs and whatever. Meanwhile, a man in a white car picked up the man with the gun. I drove around the block to the police storefront and told them about the man and several of them took off toward the apartment. We went on to CMC, where preoperatively they gave the girl a fentanyl sucker which pretty quickly got her all smiley and goofy. The surgery went well. The guy with the gun got away but an hour or so later got into a gunfight with the police on Central Expressway.
