Wednesday, June 10, 2009

Inner Cities

About two weeks ago, Robert and I went to Baltimore to see his neurologists at the Kennedy Krieger Institute.  This was the latest in a series of installments on his vitamin and drug therapy treatment.

Baltimore itself is a series of contrasts, from the Jetsons-like ramps scything their way through the air above the marshland, past the buildings with Times-Square-neon decorations that line the Inner Harbor and on beyond a new Whole Foods at the edge of Fells Point, and up North Broadway with its inner city/sad hipster mix.  When we first started visiting Hopkins a decade ago, North Broadway was a wastrel stretch of urban grit: porn theater (still there), bail bondsman with bars on the windows (very handy), discount sneaker store, various shops with Luv or Love in the title, don't-mess-with-me types jaywalking and/or drinking malt liquor out of paper bags.

Now North Broadway has a handful of hybrid cuisine restaurants and New Age shops, all with hand-painted signs featuring disproportionate lettering and out of scale images, many of them Spanish businesses, one a shop of hippie crystals and potions, an apparent Latino ministry of some sort, and poker-faced clusters of day workers stretch through a particular intersection ignoring all vehicles except pick-up trucks and drinking coffee out of cardboard cups.  And several rows of newly finished townhouses.  The Popeyes clings to its spot out of either regular patronage or sheer determination.

Past all of this lies the Johns Hopkins medical school campus, the Hopkins outpatient center, and KKI itself at the crest of a hill.

Robert and I went to a newly finished KKI outpatient center.  The old KKI building was like visiting a health clinic in a low-income neighborhood: so crowded that after patient intake data was collected, you often had to sit in the waiting room with its old-fashioned TV in a cabinet while waiting for an exam room to open up.  Bustle.  Various medical professionals jostling about.  A snack room with a wall of vending machines, an attendant selling plastic-wrapped bagels and suspect salads and weak coffee with no milk.  Low ceilings and I swear the color of just about everything except the waiting room rug was gray or beige.

The new outpatient center was half-empty, high ceilings, full-story windows, green and gold and purple furnishings and more reliable-looking elevators.  And a real cafe that we discovered later with, of all things, paninis and other hot food.  Quiet as a church on a Wednesday.

Up on the third or fourth floor, the elevator doors opened on a physical therapy clinic with shiny new machines and devices, glass walls, and bright lights.  Purple faux leather arm chairs in neat rows and, beyond, through the plate-glass, the backside of the City of Baltimore in all its unapologetic poverty and urban desolation.  From high up in a building on top of a hill, row houses multiplied as far as the eye could see in even two and three stories under an overcast gray sky and onward to the crease in sensibility that was the horizon.  A Cloverdale milk truck with its logical green and brown decorations (a clover, a cow) made deliveries below.  Row houses packed tight red and dark blue and brown and some shuttered or boarded over.  Miles of concrete and the occasional wisp of tree.

In the exam room, no one had taken the instruction tags off the ergonomic chairs.  Turning on the water in the stainless steel sink seemed like a violation.  I missed the queen-sized knee-height exam tables covered in blue plastic on which Robert and I could both lie down and take a nap while waiting for something to happen.  

What did happen, finally, made me uneasy.  All three of his neurologists entered and were positively gleeful and downright excited about Robert's aspect, attention span, and movement.  I am used to neurologists and carefully phrased comments, checked smiles, and shared looks.  

Their enthusiasm scared me because, while I know that Robert will put on his medical cloaking device in any apparent or camouflaged hospital environment, the full weight of their lifted concerns swung back and battered me with my own stored images: his aspect suddenly interrupted by his eyes rolling upward toward the ceiling (the nervous system staggering and interrupting itself), his clonus rippling like a shiver across his arms and shoulder or upward through his neck, his eyes occasionally going blank, his hairline movements. A nervous system unapologetic in its tics and starts and a human being desolate in a gray room.

I began to worry that through the worst of all of this, I had been drilling far too deep to find a person, or that I had relied on gestures of personhood to construct or resurrect a self from vestiges.  Because neurologists never get excited.

It's the biotin and the B-Complex Stress Vitamins that I had found at Whole Foods.  I am stressed.  I need that vitamin, saffron-colored powder in a translucent gel cap.  Biotin is a B vitamin.  Maybe he needed other types of B vitamins.  At any rate, we had been impatient for more change.  So we had given him the little capsules like pieces of the yellow brick road.

And now I was in Oz and the wizards had stepped out from behind a purple curtain and there was talk of a mitochondrial vitamin cocktail and Robert was moving his arms in reasonably fluid waves with some facility and holding his head up and turning it and the muscles in his face had definition.  And Dr. H looked a bit like the wizard before his wizardry inside the gypsy wagon, and we were all so surprised and pleased that the potions offered that people take for their imaginary aches and pains and incidental stress had had an impact beyond hypothesis.

And one just hoped that the little dog would not run off after the cat and we could all be in the balloon as it lofted up toward whatever might be Kansas.


Leslie said...

It seems strange and maybe not exactly okay to comment on the writing of such an intensely personal post, but this is a perfect essay that I've come back to read twice now.

Are you working on a book about this? Because there seems to be a book here, one that would help a lot of people. And one any writer would read with admiration.

jeneva said...

Thanks. I am starting to collect memories and impressions with a number of these entries. And then I'll see what I can put together.

Several years ago, my husband and I were invited to a book signing party for Mort Kondracke, the Republican pundit. His wife Millie had Parkinson's and he had written a memoir of their life together that he was using to raise awareness about the disease and about stem cell research.

We were invited because of our experiences with Robert--it was early on with his illness. When I had a chance to talk with Mr. Kondracke, he told me to start writing things down and take notes and one day I would have a book.

I didn't do that then--all of my time and energy were consumed with Robert's treatments and the search for a diagnosis. So I'm trying to do it now--out of order, just as I remember things. It makes for a strange blog, I guess!

Leslie said...

No. It makes for a beautiful blog. I'm always fascinated with what sticks in memory. For me it is hardly ever the things that "should" stick.

Plus, from what little I know from being a reader here, Robert's path seems not the least bit orderly or linear, so why should writing about his path be?

Maggie May said...

I was a little confused finishing IS good news, right? Although you were worried they were excited, they were excited because his nervous system is working so well? And you attribute this to the B capsule? I take that same capsule :) I am a huge believer in nutritional and supplemental use in fighting and preventing disease. I have a regimen I take for my own health concerns. So sounds like good news!

jeneva said...

Hi Maggie May--yes, it IS good news! I'm going to try to post tonight and explain more in plainer language.