Thursday, October 1, 2009

Instant Grits

They're probably the best snack food to keep on hand: not attractive enough to be stolen, heavily fortified, an easy meal, and sugar-free. It's the sugar free aspect that's most important. Quite a few of our clients have Type II diabetes, although most of the women who have it are thin, not fat. I believe the medical explanation for all our skinny adult-onset diabetics is that people who are genetically disposed towards diabetes are likely to develop the disease if their bodies are subjected to long term stress. Obesity is a stresser, but not the only one. Long term alcoholism and drug use are other types. Our underweight women tend to have the most serious substance abuse problems, and the result is a lot of skinny diabetics. Perhaps there are some doctors or other medically knowledgeable people reading this blog who can tell me whether I'm right or not. All I know for a certainty is that we have some very small women who recite mind boggling numbers when they tell me what their blood sugar has been and who can go through some pretty dramatic mood swings after they eat.

Diabetes is not the only illness common in our group. The long term injuries can be impressive too. Today, I watched one woman help her friend take off her jacket. The woman being helped stood with her arm out in front of her at a crazy angle like a curving tree limb. She had an unreal smile plastered on her face, and she told me that she had cried from the pain this morning. She'd had surgery on her arm almost a year ago and seemed to have accepted intense episodic pain as a normal part of her life. When she mentioned the surgery, Liz looked over and commented that she'd had two surgeries on her arm. Another woman standing nearby had chronic pain in her leg from having dropped something on it when she was doing some pick-up construction work. We have a fair number of limping women. The people who built Hezekiah House wisely included an elevator. Not having to climb even one flight of stairs is a relief to many of our clients.

Most of our clients make very little of their ailments, accepting their accumulating disabilities as an unremarkable aspect of middle age, rarely bothering with a cane or walker. With some women, though, paying attention to the physical injuries is unavoidable. Yesterday, a tall, heavy set woman came in for the first time and loudly treated the room to her biography (sexually molested by eight different people as a child, beaten by her mother when she told about it, slashed her wrists when she was thirteen, beaten in the head with a pole). "I've died five times," the woman solemnly intoned. Personally, I'd have liked to believe that this mentally ill woman had imagined it all, but there were the broad scars on the inside of her arm. There was her face, askew in three places as if the skin had to be refashioned over the crumpled skull. Who knows? Maybe she did flat line five times. Maybe every word of her litany was the God's honest truth. Certainly, she was a walking testament to her injuries.

We've had a few women with endocarditis. My understanding of this disease comes from them. Apparently, dirty needles aren't just needles previously used by people who are sick; they're also needles that just physically have dirt on them. Push that dirt into your vein when you're shooting drugs, and you can end up with bacteria or fungus infecting your heart. I think that if something else doesn't get you first, you eventually die from it. Certainly we've had young women go into the hospital then nursing home for weeks at a time with their endocarditis problems. Little Tina isn't the only one to speak matter of factly about her body not being able to get enough oxygen.

The list of health problems caused by the various forms of abuse is certainly much longer than diabetes, broken bones, and endocarditis. We had a women with fissures that opened up across her body like the cracks in the ground at the beginning of an earthquake. Quite a few women walk around with one leg substantially larger than the other. In addition to AIDS and hepatitis C, missing teeth, swellings the size of baseballs, infected pick marks, and soaring blood pressure in young women are a pretty routine part of life for the prostituted women of Baltimore.

A nurse practitioner and HIV specialist from Health Care for the Homeless come to YANA every Thursday morning, to give testing and treatment. They are nothing short of valiant as they row against the tide. We try to give out blankets and coats during the winter. I remember giving Tina a blanket last fall and hoping that she survived the cold, living on the floor of a garage. And now I've figured out that instant grits would be a good idea. There are times when I think that these little stop-gap measures are nothing short of pathetic in the face of the massive disorders our women face. Our women, however, do not agree. They're delighted to line up like they did today to get flu shots from Health Care for the Homeless. They know how vulnerable they are and how much they need the small measures. Liz beamed at me when she got the grits. They anxiously search our little supply of donated clothes for something warm to wear and revel in a good coat. They want to live. They want to get better. The woman who died five times thanked God for her blessings and thanked us, repeatedly, for the few small things we gave her.

Note: Anyone who could help me in understanding the medical issues is urged to write in with corrections, additional information, or any other comments. People who would like to donate coats, blankets, and other warm things for the coming winter can do so by clicking on the YANA website on the right hand column.


  1. How does YANA get funding to supply things such as instant grits? What do the women expect to receive when they come? Dirt on needles...hope you get and report on the medical aspect.

  2. With things like grits, or potato chips, pizza, juice, etc., I usually just pay for what I think is needed. The women have come to expect the pizza and the coffee that's been provided by another very long term volunteer, but they don't expect much else. We've had some very good medical student volunteers. The next time they come back, maybe I should ask them to do a column.

  3. I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


  4. Thanks, Alena! That's great to hear. May I ask whether you've had any involvement, academic or otherwise, with the sort of women in this blog?