A Hand in My Pocket
By J. Loknabe
I felt the blood rise to my head in a hot flash of embarrassment as they ran towards us.
Five minutes earlier, the A329 airbus had made a smooth landing at Angel International airport skirting over the tops of scattered palm trees rising triumphantly out of the tropical haze.
The porters were dressed in shabby, orange overalls and they aggressively offered their services to transport our heavy loads. We had been warned to have a multitude of small bills ready to tip our helpers. They kowtowed to the mighty dollar with eyes directed at our shoes as they begged for instant employment. As my hand reached into my pocket, they became gouging predators as the cacophony of voices and sound clamored for our immediate attention. A string of customs stops later and pounds of dollars lighter, our hands stayed glued to our pockets as the weight of frustration, guilt and impotence washed the red, gritty dirt out of our weary yet still vigilant eyes.
My next brush with impoverished humanity came when I visited Sean’s home. Now four children later, Sean still lived with his mother in the same small wooden house on the same corner street. I blinked several times to clear my head of the incredible time warp I was confronted with. Sean’s home looked exactly the same as it did a quarter of a century ago. It was small, it was modest, it was cluttered, it was dirty, and it was dark. It seemed smaller and even more modest, way more cluttered, more dirty, and darker. Even more unsettling was that his mother sat in exactly the same spot with the same look of resignation on her weathered face. A sigh, “We are surviving,” she said. I looked down only to find that snaking first in my pocket again.
I climbed the narrow stairway with trepidation. The small, shabby sign announced the outpatient outpatient offices of my high school friend, Hugh Jack. My strongest memories are of him face up on the tarmac with me straddling and pummeling him as though my life depended on it. Our famous school fist fight had created a distance even though we had become friends again.
I sat unobtrusively in the corner of his office as Hugh Jack conducted the interview. The patient, a man of forty-five years described aches, pains and numbness and tingling in his lower extremities, sweats, fevers for at least a year. And yes indeed, he had a bothersome cough and loose bowels. As my former high school classmate handed them a prescription for medicines and laboratory studies, I reflected that his handling of the encounter in the backwoods was as professional as any encounter in the big and affluent city. As the grateful patient and his kinsman bid us good-bye, I fought the strong urge to reach into my pocket yet again.
Hugh Jack suggested that we go down to the main government hospital and I agreed readily. We were there for a short five-minute drive. We entered through the main gates amidst a throng of people seeking help. I was immediately assaulted by a strong antiseptic smell that barely covered up the overpowering odor of disease. The small, dank triage room was barely sanitary almost turning my usually cast-iron stomach. This contrasted sharply with the starched whites of attendants and the nurses’ peaked caps. The rumpled, distracted appearance of the attending physician was more in keeping with the setting. He seemed not at all perturbed by the simultaneous arrival of two very ill appearing patients with acute mental status changes, one febrile and the other with loss of bowel and bladder control and both young. They looked like they would soon die. He was not barking out orders for their immediate evaluation and instrumentation. He saw my consternation and responded to my unstated query. ”My friend, do you think it matters how fast we work: We have no IV antibiotics, no supplies for invasive studies, no CAT scanner, no readily available laboratory, no well-supplied intensive care unit! Many a time, me and the other doctors, and the nurses, and the attendants, and family members, we dip our hands into our pockets to prevent imminent death. We buy our own IV drugs, access to laboratory studies and scanners, supplies, and so on! It’s a mess,” he said. “Too little, too late.” The good Doc told me he had started his private practice on the side. He could take no more of the government hospital scene. “What then?” I asked him. “Oh here?” he gestured as he looked quizzically at me. “There will be another body to take my place.”
I bit my lip hard as the tears welled up in my eyes and I felt the violent spasm of a hand in my pocket.
