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David called a few days ago – from the summit of Mount Whitney at the end of the John Muir Trail. So he’s completed the 220 mile JMT, from Yosemite Valley through the Ansel Adams Wilderness, the John Muir Wilderness, the Evolution Valley, Kings Canyon National Park, and to the top of Mount Whitney. What an achievement! It’s a good window into David’s nature that he didn’t complete the JMT last year and went back this year and did it. Congratulations son! Photo: with David in Kampot

JMT photos are here.

There is a bird feeder right outside our bedroom window and about 10 feet further into the yard is a bird bath, both in a line so that lying in our bed we can see them and Leslie and I were lying in bed this morning watching the birds and squirrel excitement and I was looking to the right of the window where Leslie has photographs sitting on top of the cedar chest and there is a photo of David and me standing in front of Becky and Mike’s house, like the photo of us in front of the Cosmic Guesthouse, at Arc en Ceil, in the Grand Canyon, at a sidewalk café in Kampot, and so on and I was thinking, the best I can recall there was never a photograph like these of my father and me. So glad the pattern was broken.

Photo: the view from our bed – actually I took the photo from right by the window. This squirrel’s name is Chubby; all the squirrels that visit us are named Chubby, except when two of them are together, then we have Chubby and the Other Chubby.

Four days from now, I’m headed northwest, through west Texas into New Mexico and up through Colorado (stop in Boulder or Fort Collins) and into Wyoming to Pinedale and on to Elkhart Trailhead and from there, a 10-12 day trek into the northern Wind Rivers, out for a night then to the southern Winds for a 6 day trek with Mike Haney.

I ran into an old acquaintance a couple of days ago, Juan (identity shielded), a Dallas Police officer. We used to hang out in the East Dallas Police Community Storefront, talking about our respective callings, fighting, good & evil, and so on. He is the cop you want to answer your call, the cop you want as a neighbor, the good cop (from a citizen’s perspective, that is). He told me he’s working as part of a team, going after serious felons (robbers, rapists, etc.) in our part of Dallas. “I’m the first one in the door,” he says, with the satisfaction of a man who’s where he needs to be. Photo: some guy playing with the siren.

Here is a true story that tells you everything you need to know to know the essential nature of this man: his partner (a good guy who I’d talked with) was killed a number of years ago in downtown Dallas, beaten down in the street and shot with his own gun while the crowd shouted to the killers, “Shoot the motherfucker. Kill that white motherfucker.” And the person who had the gun pulled the trigger and shot him dead and the crowd cheered. Juan and his partner weren’t working together that day and his partner died alone. When they took him in for the autopsy Juan stayed with the body, throughout the autopsy – which, as you might imagine, is a hard thing to do. And knowing this man, I know he didn’t look away for the cutting and weighing and so on.

I’ve thought many, many times, if I had another life, I’d love to come back as a cop, going after exactly who this man is going after, and especially I’d like to bring to justice the people who hurt children. Photo: A Karen family in Dallas. Photo by Aaron
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Found these notes from earlier this year: Sleeping at a rest stop somewhere in New Mexico, dreaming a Latin couple with a baby and someone after them, shooting with accuracy and skill and still we got away and were in this room of tapestries, old Khmer women in the shadows, wood floors and walls dark with age. I need to remember.
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Strange days have found us, strange days have tracked us down. I was driving down Peak Street yesterday and I saw a morbidly obese woman in a wheelchair French-kissing the Chihuahua she had on her lap.

I added links to all backpacking trips in this journal to the my links section on the right. The last Asia trip is also linked there. Also updated and fixed photos in the Old East Dallas Restaurants guide. Photo: front room, where I write, work, read, hang out …

So here’s the plan on food for the Wind Rivers. Basically I have 10-12 days on the trail, rest a day or so, then 6 days on the trail. So I’m dividing everything into 6 day increments – 6 days of breakfasts, lunches, and dinners in a package and so on. It’s all freezer bag cooking (FBC), which means each of the hot meals is dehydrated and carried individually in a freezer bag, to which I’ll add boiling water and put the bag into a cozy (insulated bag) and 10-15 minutes later, it’s ready to eat.

I use a super-cat alky stove to boil the water. A super-cat is a cat food can with holes in specific places. 25ml of denatured alcohol will boil 2 cups of water at 10000-11000 feet, which is where I’ll be most of the time, at least when cooking. OO stands for olive oil. I carry olive oil, different salsas, peppers, herbs (all from our garden – basil, rosemary, lemongrass, etc.), teas (for evening), hot chocolate, miso, etc.

Photo at left: dehydrator trays, one with 14 oz baby onion and the other with 3 large peppers, dehydrated. See below for what these went into.

Photos below (1st 2): where the Santa Fe tracks used to be; where David and I walked for many years (the trains were running then), first with him riding my shoulders, later with us truckin’ along side by side; where I walk now, trying stay in (more or less) shape.

Day 1
PB&J sandwich or leftover from day before, coffee.
Trail mix
Mash pot, OO, veggies, Spam or bacon, chz, salsa
2
Oatmeal, fruit, pecans, milk, coffee
Trail mix
Pasta, chix, olives, peppers, artichoke hearts, onions, etc. OO (photo is below – is this good or what!)
3
Eggs, flat bread, coffee
Bagel & chz
Chili mac, burger, chz, Fritos
4
Ebar, fruit, hot choc, coffee
Trail mix, Candy bar
Tom ka, rice, chicken, peanuts
5
Oatmeal, pecans, milk, sugar, coffee
Ebar, fruit
Spag, burger, veggies, OO, chz, flatbread
6
Eggs, flat bread, coffee
Ebar, Candy bar
Mash pts, OO, or bacon , miso soup

1
Ebar, fruit, hot choc, coffee
Trail mix, Candy bar
Alfredo, noodles, OO, chix, veggies
2
Eggs, flat bread, coffee
Ebar, fruit
Chinese food (freeze-dry)
3
Cheese toast, coffee
Trail mix or leftovers
Chili mac, burger, OO, chz, Fritos
4
Oatmeal, milk, fruit, nuts, coffee
Ebars, Candy bar
Thai noodle soup, chix
5
Eggs, flat bread, coffee
Jerky, Ebar, dry fruit
Chipotle gravy, beef or chix, noodles, veggies
6
Ebar, hot choc, coffee
Ebar, dry fruit, Candy bar
Tom ka, rice, chix

1
Trail mix, hot choc, coffee
Jerky, Trail mix
Mash pots, OO, Spam or bacon, chz
2
Eggs, flatbread, coffee
Candy, dry fruit
Thai noodle soup, chix
3
Oatmeal, fruit, sugar, coffee
Jerky, Trail mix
Spag, burger, parm cheese, veggies, flatbread
4
Eggs, flat bread, coffee
Trail mix, Candy bar
Mash pot, chix, veggies, flatbread
5
Trail mix, hot choc, coffee
Ebar, dry fruit
Pasta fresca, like in the photo, chix, peppers, etc.
6
Eggs, bagel, coffee
Jerky, Ebar
Tom ka, rice, chix

(For travel in Asia, go to 11/2008-1/2009 & see link below right; backpacking: Grand Canyon 4-7-2009, Winds 9-12-2008, Maroon Bells 7-21-2008, Bandelier 5-23-2008, Big Bend 3-12-2008)

A middle-aged woman came into the clinic today (her identity is masked here). Her chief complaints were diabetes and asthma. The promotora who saw her in intake asked two depression screening questions and on the basis of the woman’s answers then administered a more complete depression screen, which also was positive. When I saw her she said that “something happened” when she was 8 and 9 years old. Of course it turned out that she had been systematically molested when she was a child. She had not told anyone other than her mother until today. One of her children has been asking her, “Mommy, why don’t you ever hug me?” The answer, which she hasn’t been able to say, is that she cannot. There is something about physical affection between family members…because, naturally, it was a family member who molested her. She and I talked for awhile and it was intense there in exam room 4. When we were done, I told her I was glad she came in and that she had come to the right place. I gave her medications for the diabetes, asthma, and depression (or more accurately, PTSD). She’ll see our psychiatrist next week. I put a note in the chart that she should see our lead promotora when she comes back in and that she should tell her if she wants to see me or Mary (the other NP, my colleague, my friend), because (once again, of course) it was a male that did it to her. Photo: spacer, a device that helps people get much more of their inhaled medication in. They cost $20+ from medical supply places; we make them for pennies.

I’m grateful for the person who saw her at intake; for the other person who helped her in room 4; for our psychiatrist; for Mary; for the promotoras (all involved here); for Estevan, who taught me a lot about how to do these things; for the lady.

And I’m grateful that she came in and that our clinic is a place where people can come, bringing whatever they have – come in, there is room at the inn, bring it on in, whatever, we’ll do the best we can.

OK, I think I have it. I’ll drive more or less straight through (stopping a few times to sleep in the Campry (photos forthcoming eventually) to either Boulder or Fort Collins and meet Jeff. Hopefully there’ll be a fest of some kind, so maybe spend a day or so there. Photo: Early morning at camp 2, along Seneca Lakes Trail

Then on to Wyoming, probably spending the night at Elkhart Park Trailhead near Pinedale. In the morning take the Pole Creek Trail, then bear off to the north on Seneca Lakes Trail and camp around Barbara Lake (about where we camped the first night last year). The next day hike past Seneca Lakes and bear off NNW on the Highline Trail, possibly camping before or maybe at the Big Water Slide. It looks like the next campsite maybe near Lake 10935 (the number signifies that many feet above sea level), although I’d like to get to Elbow Lake. I think this is about where I’ll celebrate my 65th birthday.

The next day is short distance-wise, but takes us over Shannon and Cube Rock Passes, so it looks like a lot of steep hiking. We go north of Peak Lake and past long, narrow Lake 10740 to some waterfalls where there are some recommended places to camp (recommended by my internet buddies, offtrail and swimswithtrout). The next day, rest in the valley between Split Mountain and G-4 on the one side and Mount Arrowhead, Bow Mountain, Stroud Peak and Stroud Glacier on the other. Maybe hike up between Split Mountain and G-4 to Mammoth Glacier. I figure if I put one foot on that Glacier I can say (casually), “Yeah, I’ve been on Mammoth Glacier.” Offtrail says I can make it out on and probably across the glacier, but I don’t know. I need to limit my risk-taking. Photo: Island Lake

The next day we walk up the valley (off-trail) to Knapsack Col (the saddle between Twin Peaks and Winifrid Peak) and then down past or across a narrow part of Twins Glacier and down alongside the glacier to the stream that drains into the Titcomb Lakes and there we’ll be, in the Titcomb Basin, “a place that will haunt you forevermore” (from The World’s Great Adventure Treks). Last year we were in the Titcomb, but there was a lot of snow and wind coming down well before the col, so we broke it off there. From Titcomb, hike to our first camping spot near Barbara Lake, have a campfire (can’t have them above timberline where we’ll spend almost all our time), spend the night and head on into Pineland or somewhere where we can feast, take a shower, wash our stuff, and sleep in a bed. Photo: Titcomb Basin

In a day or so I’ll pick up Mike H in Jackson and we’ll head for the Cirque of the Towers. Spend the night at Big Sandy trailhead, or maybe hike up the Big Sandy trail a few miles and camp part way to Big Sandy Lake. In either case, end up at Big Sandy Lake. Next day up and over Jackass Pass (and the Continental Divide) and into the Cirque of the Towers. I’m thinking head west off-trail to Hidden Lake, though surely there is a trail, just not on the map. Spend another day in the Cirque. The next day go over Texas Pass (back across the Continental Divide) to Texas, Barren, Billys, and Shadow Lakes. I think there’s some campsites along there. Next day pick up the Shadow Lake Trail to the Fremont Trail headed south and on to Dad’s or Mirror Lake. Hike on out the next day.

Here are some good pieces on the Winds. The first, by swimswithtrout, is a compilation of many years in the Winds. It is transcendental. As Kesey said, he “is in deep relation to” these high and wild mountains. The second, by the inimitable “dorf” is a trip report on almost exactly the same route we’ll be taking. A very good report (be sure to click on past the map).

(For travel in Asia, go to 11/2008-1/2009 & see link below right; backpacking: Grand Canyon 4-7-2009, Winds 9-12-2008, Maroon Bells 7-21-2008, Bandelier 5-23-2008, Big Bend 3-12-2008)

I wasn’t going to post on this, but when I awoke this morning it flashed across my mind and I realized it had already pretty much slipped my mind. So, from the summer 2009 Baylor Line (Baylor University’s magazine): “Since Baylor’s first graduate in 1854, more than 140,000 men and women have earned degrees from Texas’ oldest university. (Leading up to the sesquicentennial anniversary) The Line is profiling 150 of Baylor’s most remarkable alumni …” I was one of the first 10 profiled. Here is the illustration from the profile. I’m not posting the profile because they got a lot of it wrong or incomplete, e.g., “CK’s medical philosophy is simple: ‘People at least deserve to have their illnesses treated, to at least have them looked at.'” Just their illnesses? Just looked at? Not hardly. How about, “As you do it unto the least of these, you do it unto me” OR I am my brother’s keeper OR sentient beings are numberless, I vow to save them all OR yes, there is room at the inn OR all that really matters is what you do and what/who you be.

(For travel in Asia, go to 11/2008-1/2009 & see link below right; backpacking: Grand Canyon 4-7-2009, Winds 9-12-2008, Maroon Bells 7-21-2008, Bandelier 5-23-2008, Big Bend 3-12-2008)

I was in and out of Dong Ha, the furthest north big base in South Vietnam. This was before Dong Ha was built up. From there we would go to places like Gio Linh and Khe Sanh and out in the hills to the Hill Fights. I’d been in the Hill Fights for several weeks with 1/9 and some of my gear was lost or damaged, like someone had bled all over my flak jacket and it stunk. So one evening I was going through the discarded gear outside the aid station, which consisted of several shacks with sand-bag walls and stretchers with wounded men lined up inside on something like saw horses. I was shuffling around in piles of bloody flak jackets, helmets, web gear, bayonets, ammo and so on and it was dark and misty and evil with the guys inside and the smells and the mud and I felt like a ghost or ghoul or something and was pretty freaked out. I found what I was looking for, though. Photo (above left): Karen people waiting in hallway outside the clinic

So let it go, uh-huh
And so fade away
Let it go, uh-huh
And so fade away
Walk away, walk away (from Bad, U2)

I worked for several years in home health care – the early days, before it was a business. One of the areas I worked was the Cedar Springs Housing Project and one of my patients there was a man living alone with head and neck (oropharynx) cancer with extensive regional involvement, pronounced lymphadenopathy, and cachexia. He had pain, of course, and he treated it with morphine and Vick’s Vapor Rub. He was very sick. Mostly he crawled from his pallet on the floor by the door to the kitchen and bathroom of his small apartment.

Some of the people I worked with thought he should be put in a nursing home or wherever, “so he could get better care.” He knew better and was committed to staying in his apartment. The only food he could take was liquid and he really like eggnog (Ensure was a rare commodity then). The eggnog was a challenge because it wasn’t Christmas time. So I went on ever-widening quests to find the eggnog and discovered that if you look hard enough, it’s there. Photo (above right): father & daughter

So he stayed home for several months and finally went to Parkland where he died.

(For travel in Asia, go to 11/2008-1/2009 & see link below right; backpacking: Grand Canyon 4-7-2009, Winds 9-12-2008, Maroon Bells 7-21-2008, Bandelier 5-23-2008, Big Bend 3-12-2008)

Sorry no photos. The storm last week fried my computer and some other things at the same time. As I wrote in the intro to this journal, I hope when I get old(er) someone will read these to me and I can remember some of the details of how life was.

How life is: I’m writing today sitting in the front room where all the books and many of the artifacts are (thangkas, images, betel gear, textiles, photos, etc.). It’s about the rainiest day I can remember, in the US, anyway. Electricity is still off. Leslie tells me it rained most of last night, while I slept.

David has my car and Nora picked me up to go to the clinic. When we got there, there was water in the pharmacy, work area and rooms 4 & 5. Soon it started raining again. I mopped for awhile, and then the 1st patient was ready and I started working my way quickly through the 2nd and 3rd and on and the water was rising despite several people (the usual type crew – children of two of the promatoras, several students, a volunteer) bailing and mopping and then the electric went out, but then came back in a few minutes. We were sloshing through water about an inch deep in the pharmacy and hallway and now exam rooms 2, 3, 4, and 5 and someone pointed out when we had power we were in some degree of danger of shock. Of course. So we closed the clinic, finished getting meds together for the last patients and Aaron and his students finished with the Burmese people in the hallway.

(Every time there is a big rain the water comes up through the floor into the clinic. We’re in the basement of a 104 year old church (it’s beautiful) and the drainage system doesn’t work very well. For several years we had “sewer gas” in the clinic in the mornings. That wasn’t very pleasant. Now the gas is gone, but the water is still an issue. It’s always interesting.)

So we piled into Nora’s little red car – Nora, me, Julio, Fabi, and Roxana – and started to my house. Columbia flooded and cars stalled in water up to their windows. Same for Gaston, Swiss, and not as bad on Live Oak and when Nora started slowing as the water deepened I’m saying, “Don’t stop, don’t stop.” (You say stop, I say go. You say why. I say I don’t know.) We got to my house and everybody dashed in through sheets of rain and there we were, more or less all piled up in the front room except now Leslie was there and that’s good.

Making me crazy: a few days ago someone asked me for help with psych meds (probably Symbyax or lithium SR) for a homeless person with bipolar. I told him we’re short on these meds and in fact, are switching some of our patients from more effective to less effective because we’re running out and cannot afford to buy them. I also told him that since the person he was advocating for is homeless, he could get care and meds from Parkland or from the Homes (homeless healthcare) van that actually comes to the Stewpot, where the man in need of meds is often found. And I also told him that we only care for people who cannot get services from Parkland and that our energy and resources are finite: if we care for Parkland-eligible patients, we won’t be able to serve those people with nowhere else to turn.

After this conversation he and I and others heard a talk from a well-known physician, including a brief discussion of the shortage of meds for poor people world-wide.

After the talk, the man who had approached me for meds again approached me to say that the patient’s doctor would call me – well, he says, the doctor won’t have time to call, but someone else will (assuming, I guess, that I have time to talk). I again explained our situation and my friend Shirin (who works with the Homes team one day/week) explained about services for homeless people. At some point I kind of lost it and said with some degree of passion, “We’re fuckin’ dyin’ out here, man.” That kind of closed it down, but what can I say.

Starts with a B: my first patient of the day was a woman asking that we help her with meds from an unusual set of Rxs and no distinctive set of signs and symptoms and no papers indicating a diagnosis. She had no money and had been sick with no meds for more than a month. Her diagnosis started with a B and we finally got it: brucellosis! Yes, she said, that’s it.

That’s interesting. Less than 100 cases/year in the US every year and here she was with scripts for 6 meds. We did the best we could, substituting TMP/SMX for rifampin and extending the course of treatment from 2 weeks (what was up with that!) to 6 weeks. So she didn’t get the optimum medications, but at least treatment is now for the proper length of time.

Ballin’ that jack: 52 year old man, complaining of elbow pain. Denies injury. Works digging with a shovel and pick; runs a jackhammer. Oh, right, a jackhammer. I gave him the strongest NSAID we have and some ideas re other measures, but I’m not very optimistic. So I’m making a point of really looking whenever I see someone running a jackhammer in the hot Texas sun and thinking about a 52 year old man doing that and no options. No other jobs out there. Just that. Grateful for it.

I been ballin’ a shiny black steel jack hammer
Been chippin’ up rocks for the great highway.

Doctor say I better stop ballin’ that jack.
If I live 5 years gonna bust my back, yes I will.

I hadn’t seen her in awhile: a woman came in with her two children. She used to come to the clinic and help, read to children and so on. Last time I saw her, her sister-in-law had beaten her up and she was traumatized a little physically and a lot mentally and spiritually. She moved and now was back 4 or 6 years later and her daughter, 5 or 6 years old then is now 10 or 11 and is like a Mexican Valley Girl, with all her gear and clothes and make-up and what not and still a sweet and innocent smile.

13 or 14 years ago Leslie saw a stray dog running free on our street with the dog-catchers after him. He got away from the dog-catchers and Leslie brought him home and he immediately ran from our home. I saw him later that day and thought, what a great looking dog and I brought him home. And so Judo (AKA Buddy) came to live with David, Leslie, and me. His first night with us it was snowing or sleeting and we tried to keep him inside, but he was going kind of crazy, howling and throwing himself about, so around 1am, I let him out in the back yard. I had some straw for the garden and I piled some up close to the back door, made a kind of hole in the top, got him in there and put some more straw over him. He slept all night, curled up, warm and cozy. As our friend Jay put it, he was saved.

David named him Judo, meaning “divine wind.” For months and months he would escape the back yard and at the end of the day turn up on the front porch. He would bring stuff home, like a horrible turkey carcass or a big piece of moldy cheese or most notably, a deer leg – and then another deer leg. He was always a little or a lot wild. It was several years before anyone would put their face close to his. We tried for awhile to find another home for him, but he was a tough sell – fortunately for us.

Judo was half golden retriever and half pit bull. His fur was gold and his head was big and his jaws were impressive. He was a warrior. He loved to fight and every male dog (especially the uncastrated ones) he caught out was sent running and crying or ended up on its back in abject surrender – except for Mr. G, an equally bad boy (chow) that Buddy hated and was hated right back with equal fervor. Their fight was epic and bloody and though Buddy got the best of Mr. G, the fight wasn’t over until Leslie soaked them both down with pepper spray. He was the King of our street.

Except where other male dogs were concerned Judo was a sweet dog. Well, he wasn’t sweet to cats, raccoons, opossums, squirrels, and rats. But he was sweet with humans and female dogs, especially our good old Goldy. Maybe he wasn’t all that sweet. He never tried to get people to play (except for David and me). He never, ever played rough with us – too much of a warrior for that, I always thought. Maybe the best words for me to use to describe him are warrior and dignified.

See him jumping up on the trunk of the car, to the roof, across the hood, to the ground and away. See him leap at the black lab barking, running at him (Buddy never barked as a threat – he always went in silently or with come kind of roar) and see him take the lab down to complete capitulation and whirling in the air (literally) to race up the driveway after the cat that apparently thought he could just walk around any old time. Hear him talk, “Heelllooooo.” See him leap up and then over the 5 foot high wall of the Christmas tree fort. See the greatest yawn and stretch, stretching. And every morning, beside my side of the bed – Good Morning to you too. Ahhh, Buddy.

Here is a journal entry 7/2006: Buddy went down for a long count. He hurt himself lunging trying attack two other dogs. For a couple of days he could barely stand until he’d had at least an hour of aspirin on-board. Even with the aspirin, he would fall over when he tried to lift his leg to urinate. Today he’s eliminating in every way and able to get up and down without much difficulty. And, when he came inside this afternoon he was helicoptering. AV (Always Violent) Buddy.

Over the years he became uncannily skilled at predicting where we would walk and he would lie down in our path. Door-lying we called it, and he got really, really good at it. It made things interesting going to the bathroom or down the hall in the middle of the night – “Dammit Judo!” Here is another journal entry (3/2009): Door-lying (see photo above), teetering, friendly, earish, innocent (see photo below), perfesser, helicoptering, sensitive nose Buddy, awww, just plain sensitive, donutting, truck-stopping, cute, annoying, always violent, sincere, tufted, awkward-lying, hopeful, appealing, publicity pooping, handsome, noble (see 1st photo) Buddy!

The back injuries happened several more times, and each time recovery was a little slower. His hips were somewhat dysplased and this became more pronounced over time. He’s been on daily aspirin for more than a year and for about the same length of time, unable to negotiate more than a few stair-steps. For the past several months, he’s stumbled 1-2 times every time we walk (which is every morning and every night). His right foot drags when he walks. He has had increasing difficulty lying down and getting up. He has also lost about 90% of his hearing and has cataracts.

The day before yesterday, David and I were working on Judo’s dog house and while we were doing that Judo took one of his trademark giant leaps. It was his last one. Since then he had terrible difficulty lying down and getting up. He cried when he tried to lie down and again when he got up. He could barely walk, but spent too much time pacing restlessly.

So today we took him to the vet, who offered to try a glucosamine and prednisone, the latter requiring 4-5 days off aspirin – and since for a year, missing aspirin caused him pain and because his back and hips were pretty much wrecked on the inside, we said no. So the vet gave him a sedative and within 1-2 minutes he was resting for the first time in days. He was lying on Leslie’s feet and I was sitting on the floor. Oh, what a relief to see him relax. Buddy licked my hand twice. About 10 minutes after the first shot, the vet came in and gave him an IV and he died so quietly.

Buddy died with his balls on and his dignity intact. He was a magnificent dog and he had a great life.

(For travel in Asia, go to 11/2008-1/2009)

Random thoughts in this last week of May, 2009. There were three Burmese (Karen) patients in the clinic today. Diagnoses included depression x 2, anxiety, insomnia, hypertension x 2, diabetes, nodules of unknown etiology, and so on. Two of the patients came in with our outreach worker and one with a woman involved in several Baptist-sponsored orphanages in Burma and on the border. So when Diana, the Grace pastor came down to the clinic for her weekly prayer with patients and staff in the waiting room, we all gathered (since swine flu, no longer holding hands) and Diana began her prayer (translated by Nora), with, “Dear God, our father and mother …” and meanwhile several of the Cristianas were muttering accompanying prayers and babies fussing and a toddler trying to get her mother’s attention, “Ma! Ma!” And there we all were, Mexican, Salvadoran, Karen, Mexican-American, Anglo – hearing and praying a prayer for healing, understanding, acceptance, and gratitude.

Photo above is borrowed from the Smithsonian Magazine article on Amerasians (June 2009). The older man at the table is Thao D (Uncle Thao), who came out of prison dedicated to liberating all people, including Amerasians. Uncle Thao is a Great Man, a manifestation of the beauty we all can be. See the upside down photo of the pretty girl with the checked dress on? I knew her too. Photo below: Pat B and one of her patients in the pharmacy. What a life we lead!

Later I wondered what people thought about the prayer to “God, our father and mother…”

I was saying to one Karen person, that when we were in Burma we were treated with kindness and that the country was beautiful. I didn’t say (and should have) that overall, it seems to me that people in & from Burma have a gravitas, a sense of dignity and substance. Back in the 1970s someone said, like royalty in tatters.

As part of her masters in social work, Erika R spent more than a semester in the Agape Clinic examining mental health disparities among Hispanics. Her most startling finding was that the main barrier to mental health services was that people were unaware of a mental health concern (72%).

(The following are conclusions drawn by me.) In other words, most patients who receive mental health care at Agape did not realize or acknowledge that they had a problem; they thought being depressed was just the way life goes. During the course of care for chronic or acute physical illnesses, patients are often asked questions like, “On most days are you mostly happy or mostly sad?” A positive response elicits further assessment questions and sometimes leads to the conclusion that the patient is experiencing depression and/or an anxiety disorder. Treatment is offered and provided when appropriate – in many cases, including further evaluation and treatment through Dr. K. Photo: in exam room 1.