Living and Dying in Brick City (7 page)

Later that night I returned to the hospital for my next shift and received a tragic update: The baby had died, too. The poor child had never stood a chance. He’d spent his short time alive experiencing multiple complications, including seizures and periods of unresponsiveness. Those few minutes without oxygen had caused irreversible damage to his organs. I wanted to attend Mrs. Thomas’s funeral. Even though she most likely had died before she’d reached the emergency room, I felt connected to her.

She was a fellow medical professional who had chosen to live in the city over the suburbs, a rare choice among young professionals working in Newark at the time. In the decades after the 1967 riots, census records show, Newark had lost 100,000 residents, mostly middle-income, both white and black. It was a devastating drain of talent and resources. By the time I returned home in 1999, though, the city seemed to be inching back toward a long-promised revitalization.

Politicians had finally figured out that packing poor families on top of one another in huge, poorly maintained high-rise complexes only increased crime. So the 1960s-style public housing projects that had helped to give Newark the moniker “Brick City” were being imploded and replaced by garden townhouses. But what would this revitalization mean if the city couldn’t provide basic services to protect residents like Mrs. Thomas, who’d decided that life in the city was worth the trouble?

Unfortunately, the medical examiner’s report shed no new light
on her death. It said only that she’d died of cardiac arrest. I already knew that; I was the one who’d written it on her chart. What I wanted to know was why:
Why
had her heart stopped? Why had a previously healthy young mother suddenly stopped breathing? I researched the possibilities and suspected a blood clot, or what’s called an “amniotic fluid embolism,” a rare condition in which amniotic fluid or fetal hair, cells, or other debris somehow get caught up in the circulation of the mother’s blood flow from her heart to her lungs, causing both organs to shut down abruptly.

There’s no telling how many minutes really had passed from the time Mr. Thomas first called 911 to the moment he decided they could no longer wait for help. In a crisis, passing seconds can seem like an eternity. And when a patient goes into cardiac arrest, every moment is crucial. The time it takes for help to arrive can mean the difference between life and death. A patient can die, or suffer permanent brain damage, if not treated within four to six minutes of the heart stopping.

And too often, emergency help doesn’t arrive quickly enough. An investigation published in 2005 by
USA Today
found that emergency medical systems in fifty of the country’s largest cities are slow and inconsistent and save only a small fraction of the victims who would be saved with the help of improved response times. A myriad of problems—infighting and turf wars between fire departments and ambulance services, inconsistent ways of measuring performance and response times, the lack of leadership around the issue—contribute to the delays, the investigation found. Cities that have addressed these issues head-on and improved the true time from the initial call for help to the delivery of medical services save many more lives.

I will never know for sure whether any of these potential problems contributed to Mrs. Thomas’s death. But I am haunted by the thought that a young mother who spent her days helping to save
lives had no one there to save hers in the moments that mattered most. In the end, I decided against attending her funeral. I worried that my presence might only pile on to the family’s grief, reminding them of that fateful day in the emergency room when their lives changed suddenly and forever.

I never expected to learn what happened next in the family’s life. But about a year later, I was working an emergency room shift at another hospital when I entered the room of a patient who had sprained his shoulder lifting a heavy object. As soon as I walked in, I recognized the man accompanying my patient. It was clear from his expression that he recognized me, too. It was Mr. Thomas. I had never forgotten his face, or his raw grief. All of a sudden, we were back to that awful night. I wasn’t sure what he would say. But his face softened into a smile, and before I could utter a word, he spoke.

“Thank you, Doctor,” he said, extending his hand. “Thank you for all you did.”

I asked about the children. They were well, he said. He looked well, too. I smiled and gripped his hand tightly, greatly relieved, and grateful for this rare moment of closure.

I
always took a moment to steel myself whenever I picked up a chart outside a room on the A side of the department. This was the obstetrics and gynecology side, though crowding sometimes landed a woman there because we had nowhere else to put her. I learned quickly that behind those doors, marked A1 to A4, tending to a woman’s pain often required a different sensitivity than, say, fixing a broken arm.

I’d been on the job less than a year that day in early spring 2000 when I walked into A4 and saw the woman I came to know as Debra sitting there. Something about her made me instantly suspicious. It wasn’t just her bruised and swollen face, which looked as if she had been punched. And it wasn’t the deep gash on her forehead, which left a bloody trail to her scalp and matted a patch of her shoulder-length black hair to her head. Those injuries could have happened the way she’d described to the triage nurse: in a clumsy tumble into her bedroom dresser. But her uneasiness, the way she seemed to want to disappear when I walked into the examining room, told me there was more to her story.

Sitting upright on the examining table with her feet dangling over the side, she stared at the floor, carefully avoiding my eyes. She tugged at the paper gown, pulling it around her chest to hide
as much skin as possible. I wondered why she seemed so nervous, like a child harboring a secret that was about to be exposed. When I asked what had happened, she repeated the same story she’d told the triage nurse: She’d fallen and hit her head on her bedroom dresser. But as she stretched out so I could take a closer look at her injuries, I noticed fresh bruises on her arms and legs—injuries that didn’t seem consistent with the fall she’d just described.

I placed my stethoscope on her chest and heard her heart thumping wildly. I slid the cold instrument across her skin, pushing back the paper gown slightly, and there were more bruises, deep purple and yellowish brown. I didn’t need a textbook to tell me these were old wounds. Or years of experience to confirm what my gut was telling me. I’d seen this kind of damage before … and not just in a hospital. My mother’s face flashed through my mind. I took a deep breath and exhaled slowly. This would not be an easy conversation.

“Debra,” I said quietly, recalling the name on her chart, “do you want to tell me again what happened?”

She just lay there silently at first, tears spilling from the corners of her eyes. She shook her head.

“It’s okay,” I said, trying to comfort her. “You can trust me. There are services that will help you. I can call a social worker, or the hospital’s domestic violence hotline.”

She shook her head even more vigorously—no!

But I kept pushing. “I can phone the Newark police and get someone here to protect you.”

Suddenly she was emphatic: “I said no! Just fix me and let me go!”

The silence that followed was tense. “Will you be okay to go home?” I asked. “Is it safe?”

She nodded, but I knew otherwise. I’d spent much of my childhood tiptoeing around the land mines just beneath the surface of a
volatile home—hearing, watching, my parents fight, sometimes violently. As hard as I always tried to respect my patients’ wishes, I couldn’t stop myself from prying, from trying to persuade Debra to let me help. The next questions just tumbled from my mouth:

“Why? Why are you protecting a man who hurts you?”

For the first time, Debra looked me squarely in the eyes, and I saw a toughness in her that I had not seen before: “Because Terry loves me, Doctor, that’s why.”

Terry was her husband of many years—her high school sweetheart, the man with whom she had shared half her young life. He had driven her to the hospital and now sat in the waiting room, probably looking like the perfect, patient husband. I imagined him there, fidgeting anxiously, feeling sorry for himself, wondering why his wife had made him lose his temper and do such a terrible thing to her.

Debra squeezed her eyes shut, sighed deeply, and her story flowed as freely as her tears. “He didn’t mean to do it,” she began, admitting the beating that had sent her flying across the room and into the corner of her dresser.

What a coward
, I thought, feeling anger at him rising inside me. But I tried to keep a straight face and professional distance as Debra talked about their life together. He was a good provider, she said, but even with both their incomes, they struggled to make ends meet. Like any couple, they had disagreements, she continued, and at times things got out of hand. But it was usually her fault, she added. She always seemed to push the wrong buttons in him.

“I know he has a temper, and he warns me,” she said. “But I just keep pushing.” Next time, she would keep her mouth shut, and everything would be fine.

As I examined Debra’s wounds, I thought:
I know this couple
. I’d seen their kind of “love” my entire life, the kind that can swing
violently from passion to pain with one wrong word. And even after all my years of medical training, I still had no more answers than I’d had as a boy, watching in fear as my mother and father cursed and clawed at each other.

I’m sure there must have been a time when Moms thought Pop hit her because she’d pushed him too far or talked too much. They would exchange blows one minute and talk sweetly to each other the next—or so said my older sister Fellease, who along with my other sister, Roselene, and two older brothers witnessed the worst of our parents’ battles. By the time my younger brother, Carlton, and I came along, any sweetness that had existed between our parents had turned bitter.

The only glimpse of love that I remember happened when I was about eleven. My parents were taking a photo together. My mother’s brother and sister were visiting from Cleveland over Labor Day weekend, and as my aunt Doretha snapped a photo, my uncle TJ and his wife stood to the side, and I saw my father take my mother’s hand and pull her close. It was the first time I’d ever even seen them hold hands. I held every detail of that moment in my mind: Moms in her red shorts and cream-colored blouse and Pop in a Miami Beach–like floral print shirt and blue trousers. There for a split second I saw what looked like a happy couple.

Truth was, they had carved out two separate lives under the same roof by then and most times dropped even the pretense of cordiality. They slept in different rooms on opposite ends of our small two-bedroom house—Pop in the master bedroom on the second floor and Moms on a twin bed in the basement. Carlton and I shared a sofa bed next to her.

Most days, my parents went about their business with just the required exchanges between them—a word or two here and there about a needed repair around the house, money, groceries, or the children. But the potential for a blowup always made me tense
whenever their paths crossed. I could see Moms seething and sucking her teeth the moment he entered the room.

“Ma, stop that,” I’d say, annoyed that she seemed about to provoke him into a fight.

Pop just walked around, mostly silent and withdrawn. One wrong word hurled in the other’s direction at the wrong time, though, and the sparks began to fly.

“You crazy, bitch,” Pop would shout.

“Well, you ain’t shit,” Moms would yell back.

I’d stand there speechless, praying that Moms would just be quiet or that Pop would walk away. At times, I felt like a pawn in their chess game, pushed this way or that in their effort to one-up the other, like the times when I’d run to my dad’s side as a kid and plead with him to let me help work on the car or mow the lawn. I’d tug on his pants leg until he gave in. But the moment he let me join him, Moms quickly appeared and yelled for me. I was too little, or I was going to get hurt, she’d say, ordering me back inside. She made it clear that she didn’t trust my father to keep me safe, but it seemed clear to me that she also didn’t want me getting too close to him, lest he gain some kind of advantage in their war. As a child, I wanted to be just like my father and felt robbed of those stolen moments to learn manly things from him. Other times, I’d stand silently and hang my head as Pop berated my mother in my presence, trying to sway me to his point of view.

Some days I’d hide out in the backyard in my own private spot: a pile of rocks on a dirt patch next to the garage. I’d sit there, out of everyone’s sight, and flip over the biggest stones and watch quietly as the community of worms that lived underneath scurried for cover. I’d lose myself in their quiet world. Mine seemed so tumultuous, and I always worried about what
could
happen—a fear branded into my soul by an unforgettable moment during the Christmas holidays when I was about six years old.