- Email: [email protected]
Reflections on Caring: The White Bike
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White Bike On the way home from clinic today, I saw a teddy bear face down in the street, right next to the sidewalk. Strange, I thought. Where did that come from? A few paces later, I caught sight of another one. Its plush body lay there motionless, face down. You could see the upslant of its smile on the side of its face, embroidered in red thread, its red plastic nose flush against the asphalt, probably scratched from the contact. It was obvious that its fur was once white, but it was a vague gray now. It took me a second to connect the dots and figure out why two stray teddy bears were lying in the street. Across the street from the teddy bears, less than a mile from my primary care clinic, there's a white bicycle that's always parked on the sidewalk. A wooden board bearing a picture of a black teenage boy hovers near it. His face carries only the possibility of a smile, an expression common to adolescent males wishing to appear strong. His skin is dark, and he wears a black jacket fashioned after a letterman, the collar striped with white. A few months ago, he was killed in an altercation on that very sidewalk, stabbed as a result of a fight caused by who knows what. I didn't hear about the event till much later, by which point a makeshift shrine of teddy bears and candles had formed. It was a week or two later when the bicycle took its place among those markers of mourning. The placard on the bike says his name, his date of birth, and his date of death. A tribute scrawled in purple marker says “gone, but not forgotten.” The teddy bears, I realized, were blown over from the shrine across the street. The scene got me thinking. I take care of a lot of high-risk children in my primary care clinic. Many come from impoverished homes. Far more than I would expect have one parent or both in prison. Some of my families don't have enough food to make it through the month. A lot of the children live in chaotic households, the inhabitants of which constantly shift and morph. During the 2-month visit, they may live with both parents and their paternal grandparents. Two months later, they live with their mother, a maternal aunt, her children, and their mother’s godbrother. Two months later still, the living situation has altered once more. The stability I took for granted as a child is something a lot of my patients simply do not experience. One of my patients has a mother who is intellectually disabled. I worry all the time that this patient may have a poor outcome because of her mother's difficulty understanding the instructions I give her. In our clinic, we have tremendous and wonderful resources. We have social workers on-site who can talk to our patients during their visits, offer them resources and information that residents cannot. If we have a patient who acutely needs counseling services, we can physically walk them over to the intake person for a counseling center, to ensure that his or her needs are met. Yet with all that we can offer, all the resources we have, I still worry about my patients. Like the young man whose picture graces the shrine near the clinic, many of my patients are black children. And I know it's morbid, but sometimes, when I see these sweet babies and 5-year-olds in clinic, I wonder if one of them will grow up to be a Trayvon Martin or Mike Brown one day. I try to do what I can to have a positive impact on their physical health and development, if nothing else. I exhort them to brush their teeth twice a day. I encourage their parents to be tough and disciplined with the children, lest they never learn limits. When a patient divulges deep-seated anxiety or suicidal ideation, I walk them to the counselors in the clinic. When a mother tells me she can’t afford food or find reliable transportation, I ask our social workers to talk to her about resources. Still, I wonder if I can do more. I know I've forgotten to address some of their issues. I know I'll never be able to fix it all. And every week, when I go to clinic, I see that white bike. When I would walk home after dark in December and January, it stood out in the gloomy winter twilight. The candles, some of them in glass containers bearing religious iconography, flickered around it, lending the tableau a reverent tone. The dirty gray teddy bears I saw today were Curr Probl Pediatr Adolesc Health Care ]]]];]:]]]-]]] 1538-5442/$ - see front matter & 2016 Mosby, Inc. All rights reserved. http://dx.doi.org/10.1016/j.cppeds.2016.04.001
Curr Probl PediatrAdolesc Health Care, Month ]]]]
1
once clean, new, smiling, gathered around the bike that represents that young life lost. I pray my patients will never have such a shrine built for them, though I can't help wondering if they will. In the meantime, I’ll keep doing what I can to steer their paths away from a white bike. Chaya Murali, BA, MD E-mail address: [email protected]
2
Curr Probl Pediatr Adolesc Health Care, Month ]]]]
White Bike On the way home from clinic today, I saw a teddy bear face down in the street, right next to the sidewalk. Strange, I thought. Where did that come from? A few paces later, I caught sight of another one. Its plush body lay there motionless, face down. You could see the upslant of its smile on the side of its face, embroidered in red thread, its red plastic nose flush against the asphalt, probably scratched from the contact. It was obvious that its fur was once white, but it was a vague gray now. It took me a second to connect the dots and figure out why two stray teddy bears were lying in the street. Across the street from the teddy bears, less than a mile from my primary care clinic, there's a white bicycle that's always parked on the sidewalk. A wooden board bearing a picture of a black teenage boy hovers near it. His face carries only the possibility of a smile, an expression common to adolescent males wishing to appear strong. His skin is dark, and he wears a black jacket fashioned after a letterman, the collar striped with white. A few months ago, he was killed in an altercation on that very sidewalk, stabbed as a result of a fight caused by who knows what. I didn't hear about the event till much later, by which point a makeshift shrine of teddy bears and candles had formed. It was a week or two later when the bicycle took its place among those markers of mourning. The placard on the bike says his name, his date of birth, and his date of death. A tribute scrawled in purple marker says “gone, but not forgotten.” The teddy bears, I realized, were blown over from the shrine across the street. The scene got me thinking. I take care of a lot of high-risk children in my primary care clinic. Many come from impoverished homes. Far more than I would expect have one parent or both in prison. Some of my families don't have enough food to make it through the month. A lot of the children live in chaotic households, the inhabitants of which constantly shift and morph. During the 2-month visit, they may live with both parents and their paternal grandparents. Two months later, they live with their mother, a maternal aunt, her children, and their mother’s godbrother. Two months later still, the living situation has altered once more. The stability I took for granted as a child is something a lot of my patients simply do not experience. One of my patients has a mother who is intellectually disabled. I worry all the time that this patient may have a poor outcome because of her mother's difficulty understanding the instructions I give her. In our clinic, we have tremendous and wonderful resources. We have social workers on-site who can talk to our patients during their visits, offer them resources and information that residents cannot. If we have a patient who acutely needs counseling services, we can physically walk them over to the intake person for a counseling center, to ensure that his or her needs are met. Yet with all that we can offer, all the resources we have, I still worry about my patients. Like the young man whose picture graces the shrine near the clinic, many of my patients are black children. And I know it's morbid, but sometimes, when I see these sweet babies and 5-year-olds in clinic, I wonder if one of them will grow up to be a Trayvon Martin or Mike Brown one day. I try to do what I can to have a positive impact on their physical health and development, if nothing else. I exhort them to brush their teeth twice a day. I encourage their parents to be tough and disciplined with the children, lest they never learn limits. When a patient divulges deep-seated anxiety or suicidal ideation, I walk them to the counselors in the clinic. When a mother tells me she can’t afford food or find reliable transportation, I ask our social workers to talk to her about resources. Still, I wonder if I can do more. I know I've forgotten to address some of their issues. I know I'll never be able to fix it all. And every week, when I go to clinic, I see that white bike. When I would walk home after dark in December and January, it stood out in the gloomy winter twilight. The candles, some of them in glass containers bearing religious iconography, flickered around it, lending the tableau a reverent tone. The dirty gray teddy bears I saw today were Curr Probl Pediatr Adolesc Health Care ]]]];]:]]]-]]] 1538-5442/$ - see front matter & 2016 Mosby, Inc. All rights reserved. http://dx.doi.org/10.1016/j.cppeds.2016.04.001
Curr Probl PediatrAdolesc Health Care, Month ]]]]
1
once clean, new, smiling, gathered around the bike that represents that young life lost. I pray my patients will never have such a shrine built for them, though I can't help wondering if they will. In the meantime, I’ll keep doing what I can to steer their paths away from a white bike. Chaya Murali, BA, MD E-mail address: [email protected]
2
Curr Probl Pediatr Adolesc Health Care, Month ]]]]