Friday, March 17, 2006


Helping out in the clinic today, I served as translator and nurse for some of the docs at the health center. One doctor asked me to accompany her into a room and provide translation for a visit with an 11-year-old girl and her mother. "I think it's a family or psychosocial situation", she told me as we opened the door of the exam room and stepped inside.

A lovely and sad-eyed eleven-year-old Latina girl sat on the exam table, clutching her large zippered school folder in her lap. She would clutch that folder as if her life depended on it for the duration of the visit. She wore big fake gold earrings with her name in fancy script across each one. She was dressed in clean clothes and shoes, her hair nicely combed, and pointy black leather shoes on her small feet.

The young girl's mother sat in one of the chairs, a baby in her lap (her granddaughter, I believe). I noted that the mother and baby were both quite disheveled and unkempt in comparison to the prim and proper girl.

The doctor, who speaks little Spanish, asked the girl questions in English. The girl, who prefers Spanish but speaks and understands English fairly well, would understand the doctor but look to me for translation. The mother was completely monolingual and relied upon me entirely for translation. The baby played with a dollar bill and punctuated the proceedings with messy sneezes and dubious glances in my direction.

The story seems so common. The mother, daughter and nineteen-year-old son live in a small apartment along with the mother's aunt and the aunt's thirty-something son. It's a dangerous neighborhood, which could describe most of the neighborhoods in our little city which shall remain nameless.

The entire household was asleep when there was a banging on the door just after 10pm two nights ago. The police burst into the apartment, demanding to see the 19-year-old, stating that the household was under investigation for the boy's alleged distribution and sale of narcotics. While the mother demanded a warrant or other reason for this intrusion, she and her son were handcuffed, the mother knocked roughly onto a chair. As the aunt and her son entered the living room to see what the commotion was, they too were handcuffed, the aunt being knocked to the floor by one of the officers. The unfortunate and sensitive eleven-year-old, having woken from a deep sleep, also entered the living room to be with her mother, frightened by the loud voices and nasty language of the police officers. She was summarily handcuffed as well, the mother begging the officers to leave the young girl out of it. They ignored her pleas.

Mother and son were taken to the police station and questioned, the other three remaining at home in fear, very shaken by these events. For two nights, the young girl has been unable to sleep. Suffering from migraines at an early age, she already takes a nightly medication as a prophylaxis against the dreaded headaches, but the soporific side effects of this medication were no longer providing her any feeling of sleepiness. Instead, hypervigilance, fear and anxiety now rule her days and nights, as this young innocent schoolgirl with straight A's and a sad smile tries to make sense of such an invasion of her world. Her concentration shot, her sleep cycle disturbed, her fears awakened, she is in post-traumatic stress and frightened of the world, jumping at the slightest loud noise, terrified of anyone knocking on the door. Thus this urgent visit on a Friday afternoon.

If an 11-year-old witnesses the handcuffing of her mother, that is fear-inducing enough. Being handcuffed herself and witnessing the callous and inhumane treatment of her family in their own living room by large, cursing white police officers is nightmare material indeed. This young girl was traumatized, this family's constitutional rights may have been violated, and the entire family thrown into emotional disarray. Whether the young man in question was actually selling controlled substances and is an addict himself is beside the point. The tragic violation of the family home and the loss of innocence and safety experienced by this child was paramount in the eyes of the doctor and I as we listened.

There is a War on the Poor. You can call it a War on Drugs, a War on Poverty, or a War on anything that is not "family values", but the treatment suffered by this family---and this young girl---is only a symptom of a wider social syndrome. Where is the "value" in such contempt for human dignity?

I was moved by this story, enraged, saddened, but not disillusioned. I cannot be disillusioned because I have no more illusions about the nature of law enforcement, or the place of the poor within the Machiavellian machinations of the State. In these times, such actions and tragedies abound, and not only do we propagate them here, we export them to other countries as well. For all the trauma experienced by this young woman, there are countless more in Iraq, Afghanistan, and beyond, who have experienced trauma which might destroy the souls of you or I. Indeed, many spirits are crushed by torture and rape daily, and the lion's share of this brutality is actually done in our name, financed by the taxes which we so blindly and trustingly pay.

It can be a sad state of affairs, this being human. Why can we not live up to the moniker "humankind"? Why can we not be both human...and kind? And where is that wind in which the answer was said to be blowing?


Anonymous said...

Another remarkable post, Keith. Your reservoir of compassion and understanding adds so much to the way that you exercise your vocation.

This young girl's story is an excellent example of allostasis and the need to recognise the influence of the context of her life and recent events on her presenting symptoms. In a study of diabetic children with uncontrolled ketoacidosis, researchers discovered that coaching parents in techniques that allowed them to resolve their conflicts without involving the children resulted in health improvements for the children. Salvador Minuchin famously commented that "behavioral events among family members can be measured in the bloodstream of other family members". It seems as if that could also be adapted to "behavioural events among family members can be measured in the diagnoses of other family members and governs the way that they are treated by others".

Thank you for yet another thought-provoking account from your rich experience.


Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

Wow, Tony, your comments add such richness to the conversation here, as do many other commenters as well. Thanks for the kind words, the link, and for more food for thought.....