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It was the birthplace of the outreach, lo these many weeks ago, which gives it an odd glamour in my mind. I had called and called to confirm that yes, they would be running tonight. Last week of the month sounds so unambiguous until you look at a calendar and realize that months aren't really set up that way. Weeks fall off the edges into other months until you have all these jagged little clumps of ambiguous days that may or may not constitute the last week of the month. But last month's visit was so clear: come back, it will be a couple days before thanksgiving. It was marked so clearly in my mind because I had asked for a leap of faith. The man I saw with the worst asthma ever, the one who had been in the ICU three times last year, the one who didn't remember what it felt like to really breathe. That one, I had asked to spend his last dime on inhalers. Him I promised I would come back with medicine. I had nothing that night, but this night I had a bag of donated inhalers just for him, and more. My cell started ringing. No one could find the soup kitchen. Ha, neither could I that first night, back in the beginning, when I knew nothing and no one. But that was weeks ago. It looks like a primary school. It sits in the lee of the hospital. I'll park there and flash my hazard lights; you'll find it. But when I pulled up it was dark. The kids that were playing in flocks last time were gone. The lot lights were off and we were the only cars in the lot. Dread. Dread and failure. It was the feeling you get when you're hiking back home and you see the trail you've been following leading blankly into weeds and nothing.
Nothing happens without daring, but sometimes nothing happens with it either. And this is the thing I am afraid of. Standing in the silence and the darkness and the no one. Faint glow in the window. No movement, but a light is on in there, in the building. We knock and a few people are inside. They let us in. The soup kitchen is shut down for the winter, they say. It will start up again in January. I ask about my follow-ups, I ask about the man who needs my inhalers. His sister texts that she will be there in a minute or two and shows up poof at the door. My patient had arrived at the pharmacy last week and was unable to buy anything but the prednisone. He didn't call me, he didn't ask for anything. He just sat there trying not to need to breathe until I could come to him with inhalers. I loaded him up--steroid inhalers, long acting beta agonists, nasal steroids, all donated from the drug reps. His sister was young enough to get care from the breathmobile, but needed a peak flow meter, which we gave, courtesy of the American Lung Association. Another man at the church with horribly out of control asthma got a bunch of inhalers, too. The sister needed medicine, too, but had been too wrapped up in her brother not being able to breathe and all that she had kind of forgotten to mention it to me while I was standing right in front of her last week. Is that a follow-up visit? I'm trying to tally it in my mind. I think it is a thing that doesn't have a name, a problem that waits until all is clear before revealing itself, a trust visit. Then the trail runs cold. We re-group. Back to the park, now devoid of soccer players, of baseball games. It is pitch black and silent And cold. We stalk. My headlamp gives a little circle of light that we follow, calling out ahead of us-- hello, hello... Feeling like we have to explain ourselves, feeling ridiculous-- it's Loma Linda... As if the hospital could chase after you in the darkness-- anybody need a doctor?... Rustling. Distinct rustling. I don't know why but it sounded human. Hello? A pinpoint of light in the distance resolves itself into a small pile of dominoes on a concrete table at the edge of the park. Three men are playing. They are friendly and helpful. And defensive. Yes, we are in the park at night playing dominoes with a flashlight, but this is our choice. We have jobs, we have homes. Yes, we counter, but even people with jobs don't always get benefits, even people who have benefits can't necessarily afford the medicines or the co-pay. They soften and ask for a dental referral. They point to the heart of the park, they think we may find more people there. But the trail runs cold. There is an emptiness here. We find no one. We sense no one. We call out over and over and no one answers. We check on a few follow-ups but they are not in their dwellings. A city truck rolls past us, through an abandoned lot; were they kicked out? No rustling. No sound. We re-group again. We go over the leads. We decide on a parking lot not too far away. Maybe we can find families. In the lot, a private security truck prowls endlessly. It is ridiculous, like a fish that has outgrown its tank, circling and doubling back across the neatly parked rows of shiny, well-kempt cars. It has a little yellow light that flashes on its roof, flashing private, private, private property. Move along. Keep out. You are not welcome. There is nowhere to hide in the lot. There are no edges. There is no place to rest in its brightly lit vigilance. Across the street an abandoned lot is similarly empty. It is not a vacant empty. It is an abandoned empty. It is a hastily fled-from empty. I can't explain it. It feels like a place that was once a toehold on the edge of the earth and the toehold gave way and now there is nothing but falling. The leads have run dry. For tonight we rest. Tomorrow there is the soup kitchen vaccination drive and hundreds of people expected. For tonight we rest, lost and abandoned, unwelcome and alone.
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