Waiting at the Coop

Edwina had a check-up with her oncologist, Dr. Harvey, today at Cooper Green. I headed out around 9:00 a.m. to pick up Edwina and Tyrone and dropped them off in front of the building while I parked the car.

Edwina and Tyrone at Cooper Green

Edwina and Tyrone at Cooper Green

As soon as I walked into Clinic E: Oncology, I spotted Charles.

It was Charles’s story that I had drawn on to open my story “Homeless with Cancer” in CR: Collaborations Results, because it revealed the absurdities of being homeless and having cancer at the same time. I described how Charles had been shooed away from a local clinic where he had arrived before the doors were officially open for the day. While Charles was intent on warming up from a night spent sleeping on a cold slab of concrete in a deserted warehouse before settling in for a round of chemo, the guards at the door figured he was a bum up to no good and tried to chase him out.

Charles

Charles

Charles looked the same today as he did almost four years ago when I interviewed him for the story and Sylvia followed him into his warehouse home and to other homeless digs throughout the city for photos. I have to admit I was surprised to see Charles looking relatively healthy. He was diagnosed with Stage IV colorectal cancer close to five years ago, and much of his survivorship has been spent living on the street.

Waiting for today’s chemo, Charles joined Edwina, Tyrone and me in the waiting room outside Clinic E.

He was the same old Charles, talking faster than any of us could understand him, entertaining us with vivid stories about people we knew (or didn’t, but Charles figured we should know what they’d been up to anyway).

He updated us on his brother, who’s a respected physician at UAB, and lighted up when describing the small apartment he’s currently renting (with the help of several subsidies). Charles said he liked the apartment because there was enough room for him to cook. I recalled that Charles had actually trained as a chef and worked at several popular restaurants around town before turning to the streets.

After twenty minutes of chatter, the nurse came looking for Charles to start his treatment. My eyes went from Charles to the side tables in the waiting room to scan for some reading material.

Copy upon copy of Forbes and Golf Digest. Really? At Jefferson County Cooper Green Mercy Hospital for the Sick Poor? The irony was rich.

But then I started thinking about Charles, and the many others like him who pass through the front door at the Coop. Educated. Witty. Raised in an environment of privilege. Mentally ill. A survivor of cancer and the streets. Defying simplicity.

Health care woes

Cooper Green, Jefferson County’s Hospital offering the only care for those in this part of the country lacking the income and resources to seek private care, is struggling to keep its head above water. The implications for folks like Edwina are huge.

The two departments being slated for closure are oncology (Clinic E, where I’ve spent a good many days with Edwina, Lisa, Charles, and Roderick) and ob/gyn. Since these are apparently the most expensive departments to run, the hospital is being forced by county commissioners to shut them down or go without any backing whatsoever.

There’s a lot of blame going back and forth in the local media, some saying that the hospital is mismanaged and others saying the hospital was doing ok until government folks got too far into administrators’ business. Regardless of where to point the finger, though, the outcome is the same. People needing cancer care, or prenatal care, are going to be out of luck unless they can find a way to get help elsewhere. And while Cooper Green is working hard to place its current oncology patients with facilities throughout the city, chances are that many patients who would have gone to Cooper Green now won’t seek any sort of care. Folks simply slip through the cracks.

I’ve been working with one of the key people at Cooper Green to hold the next Street Smarts event there. The program would be the same as when we held it at Church of the Reconciler, but we were hoping to offer participants this time around an opportunity to register as a patient at the facility and an optional breast exam by a doctor or nurse. The fate of those homeless women we might have reached is now uncertain.

I’ll be publishing an op-ed in The Birmingham News a week from today comparing the situation at Cooper Green with the tiered health care system in Nepal. Whether we want to admit it or not, care in America also operates according to tiers–the more a patient has money and insurance-wise, the better the care.

Stories/Lives

Earlier today, I was the speaker for the Haddin Lecture Series, a cross-campus program established by former UAB English professor Ted Haddin. I’ve been looking forward to, and worrying about, this presentation for some time now. Usually, I can keep my nerves in check, but this presentation was going to be different.

I’d be telling stories–not just shaping an argument half filled with theory and half filled with academic prose. My greatest concern wasn’t that the stories wouldn’t resonate with the audience, or that I wouldn’t tell them quite right. Rather, I was worried that the stories, like the lives behind them, might be overwhelming–to the audience and to me.

My talk began with the story of Cecilia, a woman from Zambia diagnosed with cervical cancer. Despite her knowledge of the female body from years as a midwife, her cancer ultimately could not be contained . . . largely because of a lack of resources in a nation with too few facilities and doctors to treat her sufficiently. Cecilia died earlier this year.

Next, I shared the story of the 78-year-old man (and man’s family) I had met in the hospice along the Bagmati River in Nepal. I told of his suffering and the common approach to cancer in this culture–sacrificing one’s own life for the sake of the family. I showed images of the ghats that waited for this man outside the windows of the hospice, as they have for generations of Nepalis.

Finally, I told stories that are far closer to home, sharing snapshots of cancer among the homeless: Charles, Erwin, Edwina, and Lisa.

Told together, the stories added up to a deceptively simple point: that the revolution in global health care urging community-based outreach will succeed only if those who carry medicine and advocacy to the underserved recognize and respect their stories. However foreign and multilayered those stories might be.

When the time for ending my talk had come, I still had so many more stories to tell. So much I still wanted to say about the lives I’ve had the opportunity to observe and write about. Maybe next time.