desamparado                                        

Because my mom is Italian women, usually older, often come up to me and address me in Spanish. ¿Hermana, hermana usted habla español?

No, I say, no. No habla espanol. 

Pero necesito descubrir cómo conseguir el 38.o autobús de la calle a través de la ciudad. ¿Puede usted ayudarme? ¿Puede usted ayudarme? ¿Yo necesita conseguir al autobús, usted sabe donde está? ¿Usted sabe donde está cercano el 38.o autobús de la calle a aquí? ¿Puede usted ayudarme mi hija?

She stands in front of me in the sweltering heat, sharing the small slice of shade on the scant green hill in front of the hospital. She is hunched over, wet with perspiration, face peering down at me, hands out in the air, talking. Talking. Speaking to me in a language I do not understand, asking for something, a bus, directions, how to get home. Eventually she stops and looks long at me, believing at last no habla espanol and I am left, again and always, feeling full up of all the ways I am unable to help.

parity

My 19 year old patient does not speak English, save the words shit, ouch and no. She has been brought here by her boyfriend from the Dominican Republic, the DR, so that she could give birth to their baby in America, so that they could have some kind of chance of a life told better. She has vomited three times. She is alone behind the curtain in our triage, those are the rules and she obeys them. I come in to meet her and she grasps my hand with such strength I can only think to myself, shit, that's my right hand and she's going to break it. I admit her to the labor and delivery room--small and uncertain in such growing autonomy--holding her hand, wiping her forehead. And when she says, an hour later, after I have inserted two gloved and sterile fingers inside of her to asses her dilation, her effacement, the baby's station ella es mucho más suave que el otro doctor I know only that I have not hurt her in the process, a sure sign that I am doing it wrong.

When she finally delivers I have already gone home, exhausted and spent after the labor of a 36 hour shift. I did not get to see her daughter, or say good bye, good luck, good pushing; and yet, as my first patient in what I now know is going to be the rest of my professional life, she is indelible.

gratitude

There are so many things for which I am grateful. Bird songs, coffee with milk and with sugar, soft cat-chins, Andy. I didn't want to just write a comment response thanking each of you for your comments, for still even being here, because it means more to me than just a comment thanks. Really. Really. Thank you. Thank you for checking in and I am still amazed at those of you who haven't checked out completely. I heart you utterly, messily, fantastically.