I got up late last Friday morning. On Thursday night the woman who sits under a tarp near my house and sells eggs tomatoes ginger eggplant okra cucumbers potatoes melons greenbeans peppers carrots and onions didn’t have any eggs so I decided to watch a DVD instead of making myself an omlette for dinner. I didn’t feel like cooking anyway. I watched the movie Traffic, which was focused on the illegal drug trade between Mexico and the United States.
Even though I went to bed late that night and slept late the next morning, I didn’t rush to work. It was raining – as it had been for days – and I was still sleepy, so I stretched for twenty minutes, meditated, and then sat on my bed and ate a bowl of crunchy Swiss muesli with honey and sliced bananas and soymilk.
After the rain stopped and after I finally groggily left my house, I rode to the train station in an autorickshaw decorated with looped and crossed marigold strands and big green banana leaves. When I arrived at Prem Dan I discovered that the back gate was locked, so I walked the long way around the slum to the front gate. A fat woman in a blue sari yelled at me; she called out “Hello! Hello!” so persistently that I turned to face her; she pointed to a man bent forward with both hands on a huge drainage pipe, said “patient”, and then pointed at Prem Dan. I approached the man where he stood wincing in pain, learned through his gestures that he had injured his hip, and told him and the big blue woman that I would ask inside if he could be admitted.
Joan, the dedicated skilled cynical elderly New Zealand nurse and Prem Dan veteran, who has russety-brown-over-grey dyed hair and wears stylish rectangular glasses and big white billowy Indian shirts, told me that “the Sisters” make all decisions regarding admissions, and that I ought to let the man come to them on his own. Because Joan is always in action and because she is so experienced, her perspective often seems cold or excessively callous; so even though Joan was probably right, I sought out Sister Romaric myself and asked if a new patient could be admitted; with a reluctant and non-committal smile she told me to bring him to the gate.
The man with the injured hip and his big blue spokesperson seemed surprised to see me return. I explained – incomprehensibly, I’m sure – that the man could come to the front gate with me but that it wasn’t my decision whether or not he would be brought inside. They seemed satisfied, and I asked the man if he could walk; he could not; he could barely stand. Seeing the difficulty, the woman looked at me, nodded to the man, and put out her arms with palms facing upward, as if she were hefting a big invisible weight. I had to carry him.
I lifted the man and held him in my arms and started walking with tentative heaving steps through the slum. Meeting the unfriendly but deferential faces of the people I passed, I felt a combination of pride and shame. I felt the shame of my own obvious strength in contrast to the man’s obvious weakness.
At last I arrived at the gate and set the man on his feet. He whimpered in pain when I told him to wait; I went inside and after I found Sister Romaric and brought her to the gate, she spoke with the man briefly. Then she told me his hip was broken and that he was a “hospital case”; she said he needed treatment that he couldn’t get at Prem Dan; but after regarding the man’s desperate face again she allowed him to come inside anyway. I ran to find a wheelchair for him and when he finally sat down, he looked terrified. I told him my name and asked him his; it was Saleem.
That day, Saleem was admitted to Prem Dan so he could comfortably await treatment for his broken hip. He was wheeled to the dirty rear courtyard which smelled like rotten bananas and garbage (and which always reminds me of Goya’s nightmarish Caprichos); he was given water and mouri; his body was washed and his head was shaved; he was assigned to bed F6.
(The man who had formerly occupied Saleem’s new bed had died at 9AM the day before. I never knew his name but I’d shaved his face before and each time he’d scowled in unhappy noiseless toothless pain; in the days before he died he’d started refusing food and appearing more and more horrifically thin, and his eyes sockets were dark and wet; two days before he died he asked me to shave his thick beard, and I did.)
Because I’d arrived late that morning and because I’d spent time helping Saleem, I didn’t hang laundry and shaved only a few men’s faces. During my break I drank chai with a group of pretty Spanish women and girls and then prepared to help with lunch.
I ladled food for only a few minutes; the sweet smell of steamed rice and the spiced smell of hot lentils and potatoes mingled unpleasantly with the stink of chopped-up-and-boiled fish, so I was relieved when Joan called for my help in the wound-dressing room. (I have been in the wound-dressing room only very rarely since I began working at Prem Dan, and never for longer than a minute; Joan and the few other volunteers with medical training do not invite many people to join them, and they always seem busy and preoccupied as they work.)
Joan had called for my help not because I was experienced in wound-dressing, but because the patient whose wound she intended to dress, and also – I soon realized – swab with betadine and inject with numbing solution and re-stitch with black thread, was Paul Mondle, the man who I’d visited daily for two weeks at Mercy Hospital.
By the time I got to the room, Paul was lying on a metal table and crying hysterically and babbling and pleading with Joan to stop what she was doing. Sympathetic to Paul but also respectful of Joan, I asked what she had done. She said she hadn’t started yet; Paul’s hysteria was not a result of pain, but of fear.
And I was also afraid. The old bandage had been removed from Paul’s thigh, and I saw bright red flesh with brown skin-edges on either side pulled rudely together by black stitches. Joan was of course unmoved by the minor gore of the wound; she simply smiled in the broad and genuine and mildly frightening way that older women who still wear heavy makeup sometimes smile; the original stitches were her own work, and although she admitted they were not “plastic surgery”, she seemed proud of the job she’d done and pleased with Paul’s progress. But perhaps because she noticed my fearful response to the exposed flesh and to Paul’s melodramatic lamentations, she assured me that Paul was overreacting; she said she was almost certain now that Paul was a drug addict, and that he – like all addicts – had a very low threshold for pain.
(Joan and I had talked before about the possible cause of Paul’s abscessed leg, and after hearing that he often asked for sweets at the hospital, and after seeing his response to painful treatments, and after talking to Paul’s doctor, Joan concluded that he’d been “mainlining” into his thigh. Because I’d both prayed with Paul and bought him a Bible at his request, I had assumed – naively or irrationally – that Paul was not using drugs; when I said so to Joan, she replied without hesitation that he would probably use the Bible’s pages to roll joints or try to sell it when he left Prem Dan. It was then that I remembered Paul innocently asking me the name of the bookstore where I’d bought the Bible and asking me how much I’d paid.)
I stood next to Paul where he lay and tried to speak soothing words to him. We’d never learned to communicate in a very substantial way, and that day was no different; I earnestly wanted to help him calm down, but I couldn’t. And then Paul saw Joan approach with a syringe.
He sat up fast and pushed Joan’s hands away and tried to swing his legs off the metal table and began shrieking and begging Joan to stop; Joan told me to hold him so I held him and he kicked and swatted at her hands until I pinned his arms behind his back and pushed him down; Joan pinned his legs and Paul stopped moving but kept crying “Auntie, please no!” in English and screaming in Bengali that he wanted to go home. And he said he was dying.
Joan injected Paul’s wound five or six times with the numbing solution, and each time a big bump full of fluid formed beneath the stretched skin. Paul whimpered and shook uncontrollably and started hyperventilating; I put my hand on his chest and tried to breathe slowly and steadily but soon I too felt myself becoming anxious; my vision tunneled and I felt impossibly exhausted and lightheaded; my breaths shortened; I looked outside and the clouds were twisting and moving and turning black; I looked back into the wound-dressing room and saw a man with an strangely elongated diamond-shaped face sitting in a chair and smiling; I stepped dizzily away from Paul and toward the man in the chair; both of the man’s wrists were raw and bloody and the bones in his right forearm were exposed and chipped and yellow and his right hand was enormously swollen and round. When he saw me approach he smiled more broadly and reached down to touch my feet and he did and then he touched his lips and reached for my feet again and then I stepped away and told Joan I needed to go outside and I did.
Paul’s dressing was finished in my absence without any problems, and after a quick but intense rainstorm, and after checking with Joan and sitting briefly with Paul on his bed in the men’s dormitory, I left Prem Dan through the front gate.
I was still dazed, but as I passed the slum I saw and recognized the fat woman in the blue sari and managed to communicate that Saleem was resting comfortably inside. She spoke rapidly and pointed to a child standing in the doorway of a shack nearby. I think she tried to tell me that Saleem was the child’s father or grandfather, but I couldn’t understand; the woman became disinterested and dismissively flipped her hand in the air and pushed me away; the conversation was over.
As I rode home from the train station soon afterward, I felt mentally and emotionally lost. I accidentally stayed in the autorickshaw beyond my stop and had to walk an extra mile back. I stopped at a restaurant called “Hatari” on the way and drank fresh lime soda and ate potato-stuffed parathas and brown curry. The food helped calm my mind and body, but I still didn’t know why I’d reacted the way I did; maybe I was too emotionally invested or maybe my blood sugar was low; maybe I was still thinking about Traffic.
Regardless of cause, I remained confused and unconsciously upset. And when I returned to Prem Dan the next day and saw Saleem, I asked him how he felt. He gestured that he was still in severe pain and asked for “tablets”; I saw him again later that day and he said in Bengali that he wanted to leave; he pantomimed smoking a cigarette and pointed to the gate.
My confusion started to fade, and I started to feel angry.
I was angry with Saleem and I was angry with Paul. I started to return in my imagination to the slum and to the wound-dressing room; I started to think of Saleem’s desperation and of Paul’s agony and fear, and I created scenarios in my mind that I’m ashamed and embarrassed to admit: I imagined myself telling Saleem that I wouldn’t carry him inside if he was going to choose cigarettes over treatment and that I wasn’t going to help him get painkillers, and I imagined myself grabbing Paul by the collar and saying “You brought this on yourself, now stop being such a pussy!” and slapping his ugly mouth.
I’d lost respect for both men and couldn’t quiet my emotions; I’d failed to sympathize; I’d stopped believing that “real strength” was admitting fear or seeking help or showing weakness; I’d started to hate Paul and Saleem because they were weak and pathetic and because they were addicts.
…Some of my family members and close friends call themselves addicts, and I too have indulged in most of the compulsive behaviors and addictive chemicals I know about. In varying degrees, I’ve felt addicted many times in my life. I’ve heard addiction called a disease, but in my experience it has not felt that way; honestly, it has felt like a weakness of the will.
And for some reason it feels natural to hate that weakness in myself and others; it feels natural to judge it. But even though it feels natural, I don’t think it’s right. I don’t think I really understand addiction… But maybe I don’t need to.
In part, this year has become an experiment with self-denial, and I’ve learned deep lessons about my ability to resist temptation; I’ve considered and observed and possibly overcome some addictions in my own life, but that doesn’t make me qualified to speculate on what addiction really is. And regardless of what it is – if addiction is weakness or disease – I should remember something that seemed true to me once, and still does: that societies – and perhaps also the people in those societies – can be measured by how the strong treat the weak, by how the healthy treat the sick, and by how the powerful treat the powerless.
I was embarrassed when Sister Romaric eventually told me that Saleem had left Prem Dan only two days after I’d brought him in, and I still feel off-put by Paul’s hysteria and betrayed by his schemes; truly I may have been taken advantage of, but I would rather be fooled than risk ignoring, criticizing, or humiliating a weak or diseased person.
I think now that my gross emotional shifts may not have been simple reactions to Paul and Saleem’s weakness; my anxiety and anger may have also been reactions to lingering bitterness and shame I feel about my own actions and the actions of people I care about; I may have been reacting to a reflection of my own weakness and cowardice and fear.
Paul and Saleem’s circumstances are different – just as every person’s circumstances are unique – and I don’t know everything about their lives. There may be understandable reasons for their decisions and tendencies, but even if there aren’t I believe my attitude should be the same. (And I should remember that I always feel viscerally anguished – but never angry or judgmental – when I think of ‘Caroline’, the 16 year-old girl in Traffic who becomes addicted to heroin.)
…I’ve written something like this before, but I think it can be meaningfully repeated once or twice, or maybe every day: It isn’t up to me to judge these men or say if they are strong or weak because of their behavior; it isn’t up to me to judge the symptoms of disease. It is up to me to treat all people with respect and love. (And I mean love and not pity; to pity someone is condescending at best and dehumanizing at worst.)
But even that is not so simple. I honestly don’t know how to respect and love a person who hurts himself; neither indulgence nor repudiation feels right. But I am learning. And I do know that however I treat a person, my decisions should not be motivated by anger or pride or bitterness or shame.
I also know that I should let myself be humbled by my own ignorance – by my weakness – and remember that we are all fluid combinations of vigor and illness and power and frailty; sometimes we see more of one than the other, but whether in this moment or the next we seem strong or weak, we always deserve to be loved.