Today at YANA

For those who are new to this site: YANA is a nonprofit program in Baltimore for women who prostitute or who have prostituted in the past. In the years that the YANA counselors met thousands of times with hundreds of women, they found that almost all of the clients were victims of overwhelming childhood sexual abuse -- often perpetrated by their own families. Fathers, stepfathers, uncles, cousins, and big brothers raped our women when they were little girls. Mothers, stepmothers, aunts, cousins, and big sisters pimped them out to family members, drug dealers, landlords, and strip club owners -- and sometimes molested them as well. The prostituting women we've met are often intensely conservative, shamefaced women doing what they were taught as children, while yearning for a community where they can be treated with respect. YANA is a place where they have that respect. Today's post gives an overview of the typical needs and accomplishments of our prostituted women. Anyone who wants to know more about the women discussed today can look them up through the labels on the right.

For those who are old friends of this site: today I'm posting updates on Liz, Jessie, Diane, Linda, Tina, and many others.

Liz: As the result of heroic effort by Heather, from People's Community Health, working through YANA, Liz has now had two meetings with social workers and doctors who are getting her into a detox program for alcohol, followed by a place to live. Liz has looked to be close to death for a long time. She was so thin, so often beaten up, so often in tears, trembling, praying not to die or telling us all that, "The Lord has me." Now at the age of 49, she is about to go on the "cocktail," getting treatment for her long term HIV infection (probable AIDS). She warned us all today that she'd be getting fat soon after the detox. Liz said she once weighed 185 pounds. She rocked back in her chair, legs spread and up in the air, one hand out giving us the finger. "I had a picture taken in a bikini just like this!" Then she roared with laughter along with the rest of us. "My son said, 'Mom! Put some clothes on!'" Liz has got to be Liz. Losing the addiction does not mean losing the attitude.

Jessie: She's been clean for years now, working full time at a job through her transitional program and taking classes through Open Doors. Jessie is a tremendously likable Black woman who wishes she had become a scientist, but thinks that the head trauma she suffered from an abusive boyfriend has left her "not smart enough" for serious study. Still, the hospital where she interned has called her back for an office job. She had done research work at the hospital during her internship that sounded at least comparable to the first job I got after getting a degree in English from William and Mary. Jesse has a handicapped son whom she gave up for adoption years ago when she was still using. She longs for contact with him, but knows, "I can't give him the kind of lifestyle he enjoys now." Jessie has saved $500 that she wants to give the adoptive mother to spend on Jessie's son as well as the woman's other children.

Diane: Diane is doing better with her depression and anxiety, though taking classes on her HIV status has her frightened. She gets nervous sitting in a group of people she doesn't know, especially when they're talking openly about a subject that still makes her feel ashamed. Diane, a Black woman around the age of 40, loves other people, but she prefers to do little helpful things for them without having to spend a long time involved with anything emotional. She is planning to move out of her Section 8 housing without telling her on again/off again boyfriend and abuser where she is going. This much is great. Less great is her plan to let another man move in with her at the new place. He is someone she's known and liked for a long time, but the moving in together is his idea, not hers. This is a woman who once stood at an intersection for over an hour afraid that she would be hit even if she crossed with the light. A stranger finally helped her across. Diane really does not need anyone pressing her into an anxiety provoking situation.

Linda: An older White woman, Linda is one of my favorite clients. She's back in town after spending some time in Ohio with one of her daughters who needed her. While she was gone, another daughter moved without telling her. Linda stood at her daughter's old door knocking until the police drove up wanting to know why she was there. When she answered, the police accused her of wanting drugs instead (abandoned buildings quickly become crack houses). "No sir," Linda answered. "I've been clean for 3 years, and I don't want to go to jail no more."

"Oh, I've never heard that before!" the cop told her. "I guess I'll have to take your word!" (Yes, he was being sarcastic.) Linda continued explaining until suddenly the officer realized who she was. In fact, Linda's daughter had left a message and the new address with no one other than the officer's girlfriend. He gave it to her. Linda was still amused, telling me about it.

Later, Linda (forgetting how much I already knew) talked about how she stopped using heroin. She gave all credit to Sid, telling me that Sid talked to her for 4 1/2 hours. "I didn't know she knew the signs of when people needed to use, but she did. She told me she know I was going to see the money man as soon as I left. I said 'WHAT?!" Then I told her she was right."

I doubt that Sid (our director) spent a full 4 1/2 hours talking to an addict in need of a fix, but I know she spent a long time, and I know how deep and sympathetic her understanding can be. For many women, talking to someone like Sid can be a life changing experience. Linda didn't even go into rehab. She "lay down for 3 days" and didn't use drugs anymore. And she did one other thing: she rescued a 12 year girl out prostituting on Wilkens Avenue. That experience is written up on the Whatever Happened to the Little Girl post.

Linda was in getting donations, telling me the other women in her house got into her room and wiped her out while she was away visiting her daughter. How Linda -- blunt, street smart Linda -- could have been surprised by that still amazes me, and yet, our women are constantly being surprised by the bad things that happen to them. I guess they need to believe that their friends are nicer and their surroundings are safer than they really are just to survive.

Tina: Tina, a tiny white woman in her late 30s, didn't come in today, but she was in yesterday. She's suffering from pneumonia, which may actually be good news since she has been unable to breathe for some time. She's been afraid she was about to die like her sister did recently. Tina wants to live for the sake of her sister's children. She is very sick, and she is in pain. She flags; she rallies; she makes wise plans; she comes in drooping from what has to be a fist full of street pills on top of her methadone.

The New Women: Two new women came in today, one White, quiet, anxious-looking, the other a bit younger, Black, warmer and more outgoing, dressed a little crazy. They were both court ordered to YANA. I think they both liked it. Time will tell, but Sid, feeling a little exasperated, has said that women do as well at YANA when they're forced to come as when they choose to. My guess is that even the ones who are forced soon make the decision that they want to be in a place where they are welcome and respected.

Tina's Sister is Dead

I've posted about Tina many times. I've said that she is small; she is sick; she doesn't back down from a fist fight; she believes in revenge, and she believes in family. I've said that she and her cousin Liz remind me of a pair of leathery old cowboys, bones smashed almost to dust from all the hard falls they've taken, still riding the same sad, few streets of Baltimore with death, for each of them, almost visible on the horizon.

Somewhat more prosaically, I've also said that Tina's mother tried to hang her when she was still in elementary school and that Tina believes she was infected with HIV by the aunt who regularly injected her with heroin when she was 14. I haven't written how she became a prostitute because I've never asked her that. Anyway, I think I already know. A poor family like Tina's doesn't spend daily heroin money on little girls without a reason, and what more efficient, economical reason can there be than to keep them compliant for their tricks?

Another thing I haven't written about was how much Tina loves her sister. They're close in age, and although the sister was the favored child, she was still abused more than enough for Tina to cling to her and love her. Tina's sister got the heroin injections too, of course, prostituted, got HIV and then AIDS, got sick, gotten beaten, was in and out of comas. After her children were born, she went off heroin and onto methadone so she could care for them. She married, drove a car, lived in a Section 8 house with her mother and her family. Her husband was a drug dealer and violent, but he didn't hit her or their children. On the whole, Tina's sister seemed far healthier than Tina. Still, she spent a long time in the hospital, seemed to get better, then developed some sort of strange lung infection and rapidly died. Tina's reaction has been an enormous surprise.

Tina's using fewer drugs, often far fewer, so that she can care for her nieces. Drug dealer dad is still on the scene, but Tina doesn't think too much of his parenting abilities. She's sure she can do better. The Section 8 house has already been transferred to Tina's name because, in Baltimore at least, people with HIV get faster city services. She's afraid to live there with him, but she does so anyway for the sake of the children. To a very large extent, Tina has stepped into her sister's shoes and has begun living a healthier life. I had thought her sister's death might just kill her instead.

Tina herself seems to have at least a fair understanding of how much she is helping herself by helping her nieces. She told us one day that she didn't worry too much about her own daughter because she knew her child was happy and safe being cared for by her (paternal) grandmother. All of Tina's focus now was on her sister's daughters. Then Tina said she knew she was being selfish. Of course, we assured her that she was not. It might be more accurate to say that she was being the best sort of selfish, protecting and strengthening herself through a worthwhile mission. She may have been the last sort of person Ms. Rand and Mr. Brandon were thinking of when they wrote the "Virtue of Selfishness," but she's a living example of some of their better ideals.

Faced with tragedy, Tina did not give in. She did not accept merely surviving from day to day, hoping only to avoid greater pain. Tina has a project. She has love. She has a deep desire to impose her will on her own ugly little corner of the world and make it a better place. Despite all her many wounds, Tina is just plain strong. She makes me feel the way I did when I was 14: that there will always be a great love to be had, something important to do, a big fight to be won. All those romantics who used to write about the indomitable human spirit should be so lucky as to meet someone like Tina.

Mother's Day (almost) with the Prostitutes

Today was slow for the most part, and I was bored, flipping through the equally boring books on a back shelf, more than a little resentful of the fact that YANA would close if I left early. Then, when it was finally almost time to go home, Janet came in. Janet was one of the first clients I met at YANA. Chronically stoned, speech slurred from drugs and not enough teeth, HIV positive, very actively prostituting, pregnant again with a small legion of children already scattered about the city in other people's custody, Janet sized me up and decided to call me "mom." Have I mentioned that I had no training and no background in working with prostitutes, or with addicts, or, for that matter, even with the poor? I found my new "daughter" (only about 10 years younger than I am) more than a little overwhelming. If she noticed that fact, Janet didn't care. She kept slipping me little notes about the hardships in her life and asking for small amounts of money. I didn't give her cash -- at least not all that often -- but Janet worked her will on me. I did become a sort of mom to Janet, paying her extra attention and doing extra favors for her.

It was hard not to feel for one of the most abused of all our severely abused clients. Janet's uncle began raping her when she was 3. He continued for 8 years, until he was arrested and convicted of it. He served one year in jail and was then welcomed back into the family with open arms. Janet's father began giving her heroin at about the same time. I've never heard why, but I'd be willing to bet he was raping her too or prostituting her out to his friends. What else would have justified the 10, 20, 30 dollars a day it cost him to keep her enslaved? When she was in her teens, her cousin killed her mother, and the aunts who had cared for her in the past abandoned her. When her father died many years later, Tim Bridges, YANA's deputy director, took her to the funeral. Her family hadn't wanted her to come. Apparently, they thought she wasn't good enough for them.

Despite her childhood of abuse -- and her adulthood of continuing abuse -- Janet had an oddly adorable, high spirited nature. She was an open hearted little girl who burst into tears when she was sad, then called herself a "crybaby," dried her eyes, made a joke, and went back out, smiling, to join her friends on the street. I don't think anyone expected her to make any big changes. She was our perpetual lost and loving child. Janet, however, had other ideas.

She is clean today and has legally regained custody of her two teenage daughters. The girls, who had endured years of, at minimum, emotional abuse, are giving their poor mother a run for her money. The little one shows her teacher and principal disrespect "in a horrible way" by pulling down her pants and telling them to kiss her ass. Janet, as she puts it, "perseveres." She tells them the right things. She goes to the school, monitors homework time, plays games on "family fun day" at home for as long as her teenagers will sit still for something like that. She takes them to Kennedy Kreiger for counseling. She is currently desperate for money, and we are arranging for her to talk to some people about a job. Maybe I'll slip her a hundred tomorrow, as a present to myself if nothing else. We don't see her very often any more, but it was something very fine to hear her talking today. For those of us who know what it is to be a parent, the example of Janet doing so much with so little is a wonderful thing.

And while I was talking to Janet, Tina came in with a client from the past I didn't recognize. Tina pulled out an elaborate, music playing Mother's Day card, asked the spelling of my name, and made it over to me with several inscriptions offering sweet kisses and warm hugs. She had several other Mother's Day cards as well, for, I assume, her own mother (see previous posts about the attempted hanging) and whatever other women she has adopted as her own.

The client I didn't recognize, Gloria, told me that her mother was murdered in 1992 and that her son "died at her feet" 7 months ago. I told her that we would celebrate Mother's Day tomorrow and that if she came back she might want to participate in a talk about our mothers and our children. I told her that a lot of the women had children who had died, and that many of them would want to share happy memories of their daughters and sons. Gloria seemed eager to come.

Motherhood -- the failings of our clients' mothers, the failings of our clients with their own children -- is a deeply felt theme in the women's lives. So many of them try so hard. So few of them give up hope.

Tina

I saw quite a bit of Tina yesterday. Other than her methadone, she continues to stay clean. It's been months since she nodded out at YANA. She seems to be making friends. She has even begun to take on expression in her face and voice so that she matches her own words, laughing, frowning, and smiling as she speaks. It's really sort of wonderful to be near her, and, still, sort of horrifying as well. The story of her life hasn't changed much.

Her sister has been in the hospital, very seriously ill, for more than 30 days now. Tina makes the daily pilgrimage to visit her. Because the sister had served as a buffer between her and her mother, Tina has also made the entirely reasonable decision to live in a shelter while her sister is gone (see some of the previous posts on Tina to find out what a piece of work that mother of hers is). Tina believes, also entirely reasonably, that her own health has dangerously deteriorated, but she won't get medical care herself. She wants to wait until her sister is home, with her children, not waiting on Tina's daily visits.

In the shelter, Tina met up with up with one of our old clients who's come back to town. Tina brought her in and begged a blanket for her as diligently as she begs for herself and her sister. A grad. student who comes with the professors gave the woman a beautiful, embroidered blanket that she kept in her car. Tina also brought another woman from the shelter, an older woman with what to me was a fascinating appearance. She was slightly built, hair completely covered by a red bandanna. She was wearing a jacket with a skull and cross bones motif (see superstition post for how common something like that is at YANA). She moved with the slow, hesitant gait of many of our women over fifty, and she had a face that reminded me of a turtle's -- bony, with a blunt nose and chin that protruded out at about an equal distance. Tina and this new woman, Marcy, are friends now, but apparently Marcy had previously avoided Tina. Tina explained that she had originally planned to beat Marcy up in retaliation for something a childhood friend claimed Marcy did. Marcy knowing how Tina fights ("I never stop," Tina explained) kept her distance. Tina considered, however, Marcy's age and the fact of her pace maker and decided not to. Then she found out that her childhood friend had lied, and she and Marcy are friends.

"How did Marcy know how you fight?" I asked Tina.
"She's seen me," Tina answered.

That was what I'd figured. It's hard to know what to say to any of that. For one thing, Tina weighs about 11 pounds and has one tooth (o.k., maybe a few more pounds and a few more teeth, but still, she looks like a sweet, little gap-toothed 8 year old, or possibly a wizened little, almost toothless 100 year old.) For another, Tina will sometimes stop in a fight. She's stopped before when she and the other women both ran completely out of breath. For a third thing, though, if someone hadn't intervened, she really probably would have started back up once she could breathe again. Sweet, serious, horrifically sick and abused little Tina is long on ideals and short on pragmatism. And somehow she still has the fight left in her to carry out the family ideal of retaliation. Little Tina is nothing if not loyal.

Our Client's Children, Part II

The storm closed YANA, trapped most of us in our homes, left the Washington/Baltimore area frustrated and out of sorts, but for Lilian it became a source of profound enjoyment. She used it to engineer an overnight visit with her children and grandchildren and was still glowing with the pleasure of it when she came back to YANA. Lilian, like the other women she lives with in her transitional home, is required to follow a strict schedule with curfews. She got up early the day our second storm was expected and took the long bus trip to her children's home. By the time she was "ready" to leave, there was no transportation, and she was forced to stay overnight.

"You engineered that!" Her house manager said when she finally returned at the end of her second day out. "Why else would you have gotten up so early to go out there?" I don't know how Lilian answered at the time, but she laughed gleefully when she told us the manager was absolutely right. She had engineered a long visit with her grandchildren, and it was wonderful. She even slept with the three of them and cooked for them the whole next day. Lilian also explained, quite offhandedly, that the five year old and six year old boys are "slow" because they're drug babies. The 11 month old daughter is smart, though, and fast, and "evil." And then Lilian went back to her grandmotherly pleasure in the baby's fat thighs and boisterous ways and how lovely it was to have a long visit with them at last.

I picked Diane up yesterday, and both of us waved to a little girl sweeping snow on a neighbor's porch. Diane told me that the girl, like other children from the area, visits her often. The visits were painful for Diane, though, because they make her more lonely for her own children, who live with Diane's sister. Diane does talk to them every couple days, though, and believes that she will get them back soon.

Annie went to jail recently for protecting her daughter. The daughter's boyfriend had managed to throw her and their children out of their apartment, but the daughter had returned with the help of the landlord and regained the apartment and gotten a restraining order against the father of her children. He broke back in while Annie was visiting.

You don't always know which stories you hear are true, but I thought, and Sid, with her many years of counseling expertise, also thought, that Annie was telling exactly what she remembered. Annie's eyes got big as she marveled over how fast the man moved, rushing through the door and straight at her pregnant daughter. He got his hands around her throat and was choking her when Annie's own vision began to falter. The room dimmed for Annie. She wasn't sure of all the things that happened next, but she knew they resulted in the boyfriend on the floor, his nose gushing blood, straddled by Annie. She also remembers thinking that it was her daughter who was pulling her away and only slowly realizing that it was actually the police. Annie, belligerent, hyper-aroused Annie, was the one who ended up being arrested. And within a few days, the daughter began letting the boyfriend back in for visits. "I'm not going to jail for her again," Annie announces in her flat, gravelly voice. "I've been there once. I'm not going again." The daughter still calls, though, and Annie still goes.

Tina spent a lonely Christmas in the hospital, but was cheered when someone brought her a picture of her daughter beside the tree. The little girl was smiling, surrounded by an enormous pile of presents for her and her cousin. Wisely, Tina has consented for her daughter to be raised by her paternal grandmother. The child visits with Tina often, and Tina can see that she is being well cared for. Tina explained that her daughter's father had ten brothers and sisters, and that they each were given only one present for Christmas. The women at the table all agreed that this was a reasonable decision on the parents' part and the children were probably happy to get that.

Tina didn't argue this point (though I'm not sure she agreed with it either). Apparently, however, the girl's father had at some point mentioned the possibility that one Christmas present would be enough for their child. Tina's usual monotone took on emotion at this. "Oh no," she said. "Oh no, oh hellll no." She shook her small head. "I told them this isn't the old days. My daughter can't get just one present." Tina's little girl gets all the presents her family can manage, and Tina contributes as much as she can. Whatever donated toys and clothes Tina can get her hands on at YANA (we don't have many, but Tina is actually quite gifted at acquiring whatever is in sight) go to that little girl. So does Tina's money from her small disability checks. Tina has never said anything about the toys and presents she got as a child, but she mentioned just recently that her godmother's son raped her when she was eight. Tina told the godmother, who responded by putting her over a chair and beating her with a belt. I doubt she even tried to tell her own mother.

A Note on Tina and Liz

They're cousins. I'd had no idea, but I probably should have guessed there was some family relationship. They have the same small builds, light brown hair, and regular, even features. They have the same intense love/hate relationship with their sisters, with whom they both live and by whom they both claim to be abused on a regular basis. One day they come in distraught, telling us that they have no clothes, no medicine, no place to live because their sister put them out on the street after collecting the rent money. The next day they are borrowing a cell phone to check in with their sisters and say they love them. They have much of the same illness and the same sweetness.

Tina and Liz are two of our sickest clients, the ones we watch striding the brink of death, strangely undaunted, grasping at small victories and slender attachments. They are both still ready to throw their little, semi-invalid bodies into the mix, Liz still prostituting, Tina still up for a street fight. (Liz has occasional flashes of self awareness, though. She once told the room that cars slow down for her, get a good look, and then speed off. "They're thinking, oh no, grandma's out tricking!" Liz told us. Then she roared with laughter. Tina, on the other hand, narrates a fight with another woman at the homeless shelter with no sense at all that there's anything futile and strange in a brawl between two sickly women exhausted by their own diseases. "We had to stop," she tells me. I assume she meant someone broke up the fight. "No," she says. "We couldn't breath.")

They were probably both once beauties. They are needy, and mannerly, and small. They are mentally ill. They make me think of two little old men -- leathery old cowboys, maybe -- who never retired. They keep riding the bucking bull, getting thrown until their bones are crushed almost to dust, imagining that the few sad blocks of South West Baltimore are the glorious, wide, open plains. Never guessing a world could exist beyond their horizon.

Halloween and some updates

As you know from the last post, I went to YANA armed with (overly) elaborate plans and bags full of supplies. And. . . . .almost no one came in. The few who did were not our more high functioning clients. We tried anyway. Jennifer did a good job, introducing Poe as "a guy from my neighborhood." I talked about the uses of fear and got a little thrill from the way the most ancient of the Pammys nodded and sent me understanding looks from beneath her cascade of gray hair as I said that sometimes our emotions are so big that we can't describe them with everyday words. We need to talk about demons and monsters just so that we can explain how bad something is. Pammy, and for that matter the entire room, seemed to know exactly what I meant.

After Jennifer read Annabel Lee out loud, we tried to do the group poem. I started it off with a line about a demon "on my back." Most of the people who wrote were the volunteers, however. Other, more articulate groups at YANA have done better with this sort of thing in the past. Then, as we talked about Halloween, one of the newer clients said her husband used to dress her up as a princess and the like. She made a few more, grim faced, inarticulate references to this dressing up before I asked her how she felt about it. "Not good," the woman said. "He had a gun to my head." As Sid pointed out later, you know somebody has problems when she forgets to mention that part of the story.

The new client, Mary, held forth for most of the rest of our hour or so together. She had been a military brat herself. Her husband was a traumatized vet. who did terrible things to her and then didn't remember later. He gave her black eyes and a jaw that had to be wired back together. Her parents called to ask if she was all right. She said she was because she was afraid, then she was more afraid that God would punish her for lying. At last a general came to the house and made her husband stop. In court, her husband jumped over the table to attack her, but this time she fought him off herself. The weeping female judge told the bailiffs to stand back and let her do it. Later, her jealous sister got her put away in a psychiatric hospital for two years, but she found a way to do good there. She listened to others and tried to help them.

For Mary's sake at least, we turned out to have exactly the right group of people. They weren't talkers. They weren't judgers. They weren't interested in drawing attention to themselves. They listened in quiet support. Our Sister Mary said the right things about how well the woman had done and what a long process it is to forgive an abuser. I don't think Mary the client could have spent a better hour. She told me so many times afterwords how relieved and happy she felt about being able to talk that way. She said she couldn't usually tell people what happened to her and that we "just drew it out of" her. For myself, I was feeling a little sick from too much peanut brittle and candy, a little disappointed that we hadn't produced a collection of meaningful poems, a little foolish and annoyed with myself for caring about the poems, and more than a little depressed from the experience of listening to the drawn out ramblings of a mentally ill woman with no idea at all of how to help her. Even I couldn't help but notice, though, the relief that filled that woman by the end.

For the rest of the clients -- I don't know. There were so few of them that they got a lot of candy and Halloween socks and little toys. I'm sure they liked that. They could have left at any time, but they stayed. My guess is that actual community, rather than an art project and discussion of metaphors, probably did them good. The point of YANA, after all, is to listen and support. Maybe, in their quiet ways, all the women there felt a little more like family.

UPDATES:

I forgot to mention that Tina came in Wednesday, dressed as her usual rag doll self. She had gone to the funeral, but stayed only briefly. She said that her cousin was so heavily made up that he didn't look like himself. The backs of his crossed hands were more or less flesh colored, but the palms were purple. After she saw that, she had to leave. Tina hadn't talked to Sister Catherine yet, and Catherine wasn't there when Tina came in. I told Sister Mary about her as well, and now there are two vigilant nuns primed to find Tina and reassure her of God's love.

I asked the youngest of the Pammys if she would mind telling the room about her HIV status. She didn't mind people knowing about the disease at all, though she was rather floored at the public speaking aspect once I announced that she had something to say. Pammy was diagnosed about seven years ago with HIV. This past February she became AIDS-defined because her t-cell count had gone below 200. She got on the "cocktail," and her t-cell count went back up to 359. Her viral load is so low that it's undetectable. There may not be a cure for HIV, but apparently you can come back from full blown AIDS. The room applauded her.

Best of all -- I asked Diane if she'd heard anything about the client that the little mean woman said had been arrested for arson and murder. "I haven't heard anything," Diane said. "Since she went into the program." According to Diane, the client had been hospitalized again, then moved directly into rehab. The client really was very sick. This move from hospital to rehab. happens. It makes a lot more sense than the client having been let out of jail. And Diane knew the client much better than the little mean woman did. Of course, I didn't repeat the rumor to Diane. I have the feeling it's nothing more than that.

Another Day at YANA (Almost Halloween)

Today, Heather, our volunteer psychologist, offered to lead a group discussion on anxieties and how to manage them. Unfortunately, I had the bright idea of starting the discussion off by announcing to an already very chatty group that we would talk about anxieties because it was almost Halloween. I said it because I was trying to get their attention, and in that I was certainly successful. The women were all electrified -- but not in the sense of animated debate so much as in the sense of hair standing on end, eyes throwing sparks, tossing information about the Halloween gang killings back and forth as if they were trying to get rid of a live hand grenade. According to the women, the gangs planned to shoot 31 women to death for the month of Halloween. They said that the shootings had already begun and that 13 women were dead so far.

Tina, who I believe has lived in the area all her life, was astonished. Almost all the other women seemed to be in the know, echoing the numbers of dead and soon-to-be-dead and reminding each other that there would also be a lot of rapes. They said the women were shot all over the city, and that anyone could be killed. They advised Heather and me to drive straight home, and they advised each other of where to hide and what to scream if the hiding wasn't successful. Heather, who turns out to be an impressively patient young woman, sympathized briefly, and asked what else, besides the possibility of being shot, made them feel anxious. A woman whose name I haven't bothered to learn yet, preferring instead to think of her as "the little mean woman," treated the room to a discourse on her fear of being shot while sitting with her aunt in the front row of church. She justified this by reference to a robbery in a different church something like a year ago. As I've written before, not many of our women go to church -- or maintain a particularly good relationship with their families for that matter. But at least they all got to know that the little mean woman did both.

"Worry about your safety in the street and in church!" Heather said kindly. She gently prodded for other causes of anxiety. Kiki began a rapid fire explanation of someone who owed her 7 dollars and who had the nerve to accuse her of having an attitude when she needed the money back, and she really needed the money, and she wouldn't have asked if she didn't, and . . ." "Worry about money," Heather said with grave sympathy. "A lot of people worry about that." The other women filled in eagerly with advice. "You're not getting the money back," Tina swiftly informed her. There was prompt and enthusiastic agreement on this point. Kiki still wanted to watch out for the debtor after he got his check, but, again, she was warmly and swiftly advised to let the matter go. Grudgingly, I will admit that even the little mean woman was helpful on that point. And as for Kiki, there really was nothing petty in her concerns. She's pregnant, collecting free baby clothes from our donors, and genuinely worried about her own ability to give and withhold. She was afraid of not having enough. She was afraid of becoming the sort of person who wouldn't give anything to a person in real need.

Somebody else said something about people who died in Pakistan and praying for them. We don't have the kind of group that talks about pet peeves and minor annoyances. It's gang killing, rape, robbery, betrayal, poverty, and war with them. Heather and I sort of had manageable little phobias in mind. Finally, in reference to I don't know what, Kiki said something about claustrophobia. I loudly (and truthfully) announced to the room that I'm very claustrophobic. Nearly all the other women said they were too. "How about fear of heights?" Heather asked. Another problem for most of the room. It rapidly became clear that murder, rape, and the rest don't preclude all the other fears. Mentions of snakes, spiders, mice had most of the women shuddering.

Heather began a discussion on how people's bodies feel when they're anxious (racing heart, shallow breathing and the like), then asked what we do when we get to that point. "I used to just sniff dope," Jennifer told us. "But I don't do that no more." Other people talked about going to their "happy place." Heather talked about deep breathing. Some women had to leave. Another woman, Lilian, came out of the bathroom wearing a very attractive pantsuit she'd found in the donations. The rest of the group burst into a frenzy of praise. "Now I have something to wear to church!" Lilian said. "Last week I wore jeans." At this point the group was divided between continuing to praise the church clothes and reassuring her that it didn't matter what she wore as long as she went. Not too much else got down in the anxiety discussion.

The little mean woman managed to tell me about a neighborhood woman who set fire to an abandominum, planning to kill one person and accidentally murdering a man who was asleep down stairs. The woman she mentioned was a YANA client who hasn't been around for a while. She was troubled. She was living in an abandominium. She was involved in some fires, and Liz told us months ago that the police were looking for her. I said nothing to the little mean woman. It's possible that the rumor is true.

Patient Heather was pleased with the initial discussion. She plans to hold further groups on how to implement some of the anxiety strategies. Pammy came in with her mother who is also named Pammy and with an elderly friend also named Pammy. The three women seemed fairly pleased with their names, and the eldest Pammy smiled in genuine amusement when asked if she was the great grandmother. The youngest Pammy (herself a grandmother) had been diagnosed with AIDS earlier this year because her t-cell count was so low. Apparently, it's back in the healthy range now, and her viral load is undetectable. She beamed as we exclaimed over her obvious health and well being. Lilian hugged me for a long time before she left and said that she thought of us often. Another woman, Sheri, came in just at closing, and I gave her a birthday card from Daniel (son in the pictures) and myself. I got a lot of hugs from her too. She said her birthday hadn't been very good and that she would "cherish" the card. Excitedly, she told she was making something for me and Daniel for Christmas. The women, especially Lilian and Tina, took it on themselves to clean the room and take out the trash, then filtered out for another day. As we left, Tina told us again how afraid of elevators she was. She said that the emergency phone in an elevator at a hospital didn't work, and when she got stuck she ripped it "down to the wires" trying to call somebody. People heard her screaming, though. She left for her sister's house before going back to a shelter. It was another day with pretty much the usual mix of women at YANA

Tina and Liz

I didn't get to see Tina the next day because I left early to give a talk at Notre Dame. I did see Sister Catherine, though, and told her about Tina's belief that anyone who overdoses goes to hell. "Oh that old Catholic teaching," Catherine said. "I'll keep an eye out for her." Catherine spoke with the kind of determined growl you'd expect from an undaunted old nun who'd spent her life defending the poor. I hope Tina came back in that day. I was sure she'd be in good hands with Catherine.


I saw Liz for a while that morning. She was much her usual self, sad, victimized, worried about her future, eating grits, and finding some new clothes so she could begin her transformation into a loud mouthed, laughing, sexy -- albeit toothless -- woman again. Then she gave me two bucks. I'd given her a five for her three dollar copay on her zoloft prescription. She brought me change. Most of the time, Liz lives on the street. She has switched from heroin to vodka, but she is an addict all the same. She is also damaged in more ways than I can count. And she matter of factly brought me change I'd never asked for. If you've never worked with addicts, you may be wondering why I'm bothering to write this. If you have worked with people like Liz, all I can say is that it really happened. I swear it.

Tina Gets a New Dress (The Lord Provides)

Tina came in Wednesday sober and coherent, as she's been for the past few weeks, but obviously sad. Her cousin had died. He had been released from prison a few days earlier and had already been found dead of an overdose in an "abandominium." She had come to YANA to find a black dress for his funeral. In the strange way that things so often work at YANA, there was one black dress in our little donation closet. It was an absolutely gorgeous Liz Claiborne, and it fit her perfectly. Tina looked through our 7 or 8 pairs of shoes and found a very cute black pair that also fit her perfectly. Ditto for our one black blazer.

The other women all began to fuss over the sight of our usually woebegone little stick figure in rags transformed into a runway-way thin model with the great outfit. "Is someone going to take her picture?" Jennifer wanted to know. Heather, our volunteer psychologist, got her cell phone. Tina hurried to the bathroom to fix her hair, and another client said, "Let's do it professionally!" and set up a screen to serve as a backdrop for the shoot. Heather took a few pictures; the room admired Tina, and Tina, staring at the images on the phone, asked if she could get copies. She said that her mother would probably want to enlarge the pictures and hang them on her wall.

Tina's mother tried to hang Tina when she was eight. Tina's brother stopped her, but to this day, when mom gets drunk, she tells Tina, "I should of kicked that chair out from under you when I had the chance!" She curses Tina and hits her when she lives with the family. Much of the time Tina survives on the street or in shelters. And, I can imagine that Tina's mother really would hang up the picture proudly. Our clients have very complicated family relationships.

And, certainly, all the women at YANA were delighted with Tina's good fortune in finding such good clothes. Again, I heard the word "blessing" and the explanation "This is how God works" far more than I would have cared to, and, once again, I managed to restrain myself from saying anything along the lines of "Halli-fucking-luah a 22-year-old is dead, but Tina has nice clothes!" For all that Tina really was pleased with both the outfit and the attention, she was still grieving deeply.

She got me aside a bit to talk again about her cousin's death, and for the first time in the nearly five years I've been at YANA, I heard what one of our women thinks about the afterlife. It was every bit as bad as I'd feared. Tina said that since her cousin had died of an overdose, he had committed suicide, which meant that he was in hell. She said that Jesus suffered and died for our sins, and instead of finishing that sentiment with anything about forgiveness or redemption, she said contrasted his goodness with her own evil and shook her head, grim-faced. Tina told me that she wanted to be with Jesus and the angels, but she didn't think she had much of a chance. After all, she explained, there was no excuse for the things she did.

I didn't know what to say to Tina. We don't tell people how to feel about religion at YANA, and we especially don't do it if their belief in the damnation of addicts who overdose might be what's saved their lives so far. Add to that the very real possibility that smashing through a fragile person's self definition might have more consequences than I know what to do with. . . and I decided to fob off the whole problem on someone else. I asked Tina if she would like to talk to Sister Catherine when she came back, and Tina eagerly said she would. I figured that Catherine's decades of comforting the downtrodden would serve her in good stead.

I also didn't know what to say to Tina about her grief for the loss of her cousin. She said she worried about going to the funeral. She said her last funeral was for her grandfather she'd only seen once in her life. She said she tried to pull him out of the coffin because she didn't want him to leave her. How do you comfort someone who feels her losses that deeply? My answer was to give her a couple of bucks for bus fare and to accept her hugs and thanks for having done "so much."

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.

Tina

Tina is another of our tiny, dying clients. She has a stick figure body and a face that makes me think of a child's little drawing: mouth, nose, and eyes all sketched with a few straight lines, a fringe of short bangs on her forehead. It's a sweet, slightly quizzical look without much force behind it. Often, as she feels the effects of her methadone -- considerably enhanced by high dose xanex bought on the street -- she moves like a little stick figure losing its animation, swaying and bobbing, eyes shut and mouth open, taking minutes to raise or lower the Styrofoam cup filled with lukewarm coffee. Even her hands are like something a child would draw, although, in this case, we're talking about a bored or slightly malevolent child. She has some fingernails that stop short of the end of her fingers and then grow straight up, so that they're perpendicular to where they're supposed to be. They can get quite long, and thick, and rather yellow. These witchy growths on her otherwise unmarked body are caused by a virus.

Tina, who is in her late 30s, spent much of last winter sleeping in her boyfriend's mother's garage. She has AIDS, which she says was acquired through being regularly injected with heroin at the age of 14 by her aunt. She has many of the diseases and the fungal infections that typically go with it. Her t-cell count (often 800 or more in a healthy person, dipping below 200 for someone with AIDS) tends to remain below 40. She is, appropriately, on none of the AIDS medications. She couldn't maintain the regime, and the drugs do more harm than good if they're started and stopped, mixed with everything else she buys on the street. She says that her doctor is frustrated with her, and it's obvious that she doesn't blame him. Tina's blood pressure is also extraordinarily low, and she speaks matter of factly about her body's lack of oxygen. When she goes to the E.R. she's like a t.v. character going to Cheers -- everybody knows her name.

And everybody seems to like Tina, or feel sorry for her, or tolerate her anyway. She is so much like a little disabled child that it's hard to remember she's a woman, but she is. She has a boyfriend. She has a two-year-old child she adores (don't worry, too much, anyway, the dad's family has custody). She can get very angry when she thinks she's been insulted, and she will apologize at length weeks after an incident if she sees a person she thinks she spoke to rudely. She is aware enough of what her life is to feel despair. Suicide is a recurring consideration.

It was both reassuring and depressing to listen to her yesterday talk about her past. Boys in the Hood was on our little V.C.R., and Tina, looking over at it, remarked that if the characters got revenge they'd go to prison. Then she continued in her soft, slightly gravelly, no-preliminaries monotone to tell about her own revenge history. "In my family," she said,"When anything happens to anybody, mom, sister, brother, grandma, doesn't matter, the first thing we think about is revenge." I can believe that. Not too many months ago, her mother hit her in the face. Tina didn't react because her little daughter and niece were in the room. Tina's mother called her a "pussy" for not hitting back. Normally, the women would fight.

Tina told me that when she was in a half way house when she heard that someone had hurt a close friend. The first thing she did was call a cab, then go on trash can duty so she could get outside. The cab came, and she ran for it, but somebody at the halfway house stopped the cab from taking off. Didn't matter to Tina. Nobody had hands on her yet, and she went flying down the street in a bright green sweatsuit, ducked in an alley, unzipped it, and reappeared in the red sweatsuit she'd hidden underneath, flagged down another cab and kept moving. "You'd of thought I did murder someone," she said. "The way they kept showing my picture on the T.V. They said I'd escaped from prison, but it was a halfway house." I asked if she got revenge while she was out, and Tina made one of her mild adjustments of expression, tending towards surprise. Of course she had gotten revenge. And later, when she and the offending woman were both in the same jail, she got it again.

And she didn't get caught anytime soon, either. Police came to her home, and helicopters circled the skies above it. She ran to the roof of her stepfather's club, white trash bag in her hand. Tina hid in the snow, beneath the white bag, unseen. I'm (inappropriately?) delighted by this image of her determination, her foresight in grabbing the trash bag, her winning something for once. Perhaps with some of the same feelings I'm having, Tina went on to talk about her little sister who, as a teenager, tried to jump out of a moving police car. She named the two police who had her at the time, one of them, Officer Smith, is a man I've heard quite a bit about. Officer Smith and partner took the little sister into a walled alley for a discussion of her escape attempt. While Officer Smith was cracking her ribs, Tina's little sister managed to blacken his eye and give him a bloody nose. Tina modified her expression again towards slight amusement. "I heard the other police made fun of him for that 'cause she didn't weigh but a hundred pounds."

Tina quietly chatted a bit more. She said she didn't mind prison except for the first few days she spent in drug withdrawal. Otherwise it was fine. "I skate all over there," she said with a tiny smile. "It's because I was locked up so much when I was a minor. I became institutionalized." A fair enough assessment, I suppose. She'd probably be better off in prison now, but there's life inside that little doll-like figure and surprising sweetness too. I hope she'll keep coming back.