vignettes from day before vacay

always seems like the day before vacay is craaaazy. patients make us work hard to earn our time off. hah!

some memorable patient experiences... all in one day.

-J is a 75 y o man who loves the Lord. he did ministry in puerto rico and north philly most of his life, i think. his denture tooth chipped. i forgot to send it to the lab. genuinely forgot. not intentionally forgot like i sometimes have. sigh. getting better! anyway. i had to repair it myself the night before. it turned out all right! i gave it to him this morning. it took 2 minutes. he says, "that's it?" so i respond with "do you want me to pray with you?" his eyes lit up. i asked him what he wanted prayer for. he said, "the Lord knows what's on my heart!"
sure. but i don't! so, you might as well tell me. haha. i don't mean to probe. it just comes out. and people don't mean to tell me their business. they just do.
anyway, his prayer request was that he is deciding whether or not to travel to puerto rico. a friend or perhaps someone from his church offered to pay for his travel expenses. he knows he wants to go, but he is not sure whether or not it is for selfish reasons. if he goes he wants to go with the right heart. if he stays, he wants to have the right heart.
awwwwwwwwwwwwwwwwwwwwwww. this was really refreshing because most people have some kind of physical world crisis. someone just died. someone has cancer. someone's in jail. can't pay the bills. someone's father just left. ...etc... etc... just as important to our Father are our heart battles. coming from my church in michigan... i'm no stranger to heart battles. it seemed that's what we spent hours and hours praying for each week. ...how to align my will with God's Will. sometimes it seemed a little excessive. especially while the rest of the world is in crisis - hunger/famine, war, poverty, slavery, prostitution, persecution, disease and drought. not sure where that balance is, but i don't feel burdened by that, since God holds the world in His hands.
J was really thankful for time to pray together and was encouraged. of course that makes us all feel warm and fuzzy. there's a part of me that's like, "...i didn't have to spend 4 years and $160k to learn how to do that..." -__- but i suppose i wouldn't have met him in that moment, in that dental chair, if i hadn't invested that time/labour.
i guess it's sorta encouraging (?) to see a 75 y-o who is supposed to be more sanctified, but also more of a sinner.

-J was a new patient. goes to one of our partner churches. needed a few teeth removed. next door when waiting for her to come back from feeding her parking meter, i told tai that my neighbours were singing 'pon aceite' on the porch the night before. it was 10 p.m. and i didn't know what was going on. maybe some impromptu pentecostal sing-fest. so tai started humming 'pon aceite'. J came back and while i was trying to dig out #3 MB root tip she goes, "what are you humming?! is that 'pon aceite'?!!!!"
yes.
then. we sang.
we sang 'pon aceite', 'alabare', 'los que esperan', 'si tu vieras fe',  'has cambiado me lamento in baile', and 'bueno es alarbarte y cantar'.
it took 6 songs, and some surgical bur to get that bloody root tip out. had to elevate the crap out of that. J was super happy to sing songs she hadn't sang in a while, and was going to sing them all at church on sunday.
so weird. weird dental practice. weird.

-N came back to have her tooth removed. today she was wearing a sleeveless shirt. her R arm had a portrait of a young man, with RIP nick. end date was march '12. turns out her son was shot 3 times at an intersection near their home. her story is that he was 18, just walking home, random folks shot him. i would like to believe that is the story. i maybe believe it 75%. she has 5 other children. 1 older, 4 younger. it could have been random folks looking for someone else. or there could have been a side story of conflict and trouble. they didn't take his belongings or jewelry or money. they might have just been wanting to shoot someone.
her tooth would not get numb. finally got it out.
prayed for her and her family for the Lord to keep us all safe in the streets. and for healing of her poor mother's heart in mourning.
the only response in these situations is to give it up and pray.

-W brought in her son G, after calvin sorta threatened to call DHS if she didn't stop no-showing. i had seen G on my schedule, cancelled/no-showed/came and walked out several times. i had forgotten who he was until i saw W walk down the hallway looking for the bathroom. holy moly.
... rewind to last year. G is the one, i met him when he was 4. he told me he had 4 siblings. i asked if they were mostly older. W told me they were all younger. i paused. is she a baby machine? W told me that two were from the dad's mistress. and that she wanted all the kids to be friends. but, the mistress was causing too much drama. that's why they relocated from where they were to philly.
... meanwhile she told tai at the front desk that she had to get away from her hubs. she was pregnant and sleeping in the bed. she woke up to him banging the mistress in the same bed. wtf wtf wtf wtf wtf?! worst story evARRRRRRrrrrrrrrr!!!!
so of course, every time i see her now, i can't shake that story. i can't dissociate her with that.

only by God's grace and mercy alone is G the sweetest, wittiest 5 year-old boy in this hood.

sadly had to remove baby molar from G due to progressed caries. he was tough and brave and didn't even flinch. Lord have mercy on us all.

-K is a 13 year-old. i saw him walk to Ada's chair and noticed lots of markings on his L arm. when the cleaning was finished, i walked in for the exam. the tattoo was not temporary. it was definitely real.
"oh hey! lemme see your tattoo!"
"your mom let you get that?!"
"that's your nickname?!"
"did you design it yourself?!"
"are you gonna do your whole sleeve?!"

if you want answers. just ask like a valley girl. "what happened?!" it shows concern. it shows genuine interest. and it erases any suspicion of judgment or malice by sounding too ditzy to know how to use this information against them in the future.

K tells me he wants to do his whole arm, but he wants to wait until he is older.

the only response i could come up with off the top of my head was,

"yeah. it's good to wait until you're older. you never know how big your arm is gonna get, so some tattoos might not look right when the proportions are off." (or when you get hair on your arm?... who knows)

WHAT?!

it was the end of the day. i've never been in this situation before. i never got to practice responding to 13 year-olds with tattoos.

maybe what i should have said was, "THINK TWICE AND THREE TIMES AND A HUNDRED TIMES BEFORE YOU GET THIS PERMANENT ARTWORK ON YOUR BODY BECAUSE IT WILL COST THOUSANDS OF DOLLARS TO REMOVE IT, AND IT MIGHT PREVENT YOU FROM GETTING A GOOD JOB IN THE FUTURE."

i don't mind tattoos. (except for the devil tattoo on M's face, and the "f--- life" on C's eyelids, and all the other vulgar tats that i see coming in periodically).

i have chosen not to get any because of possible travel to other countries where they are not as accepted/tolerated.

i appreciate a lot of tattoos if it is good artwork. i also think it is really cute when some boys wear earrings. or when the majority of hispanic girls have their earrings at 2 months old.

but to trust a young teen with a decision that has permanent consequences is maybe questionable. there is a reason why many things require 18 years of age/18 years of brain development.

snapshot of philly public schools

me: so, did you learn anything interesting in school today?
8 yr old pt: no.
me: you didn't learn anything new?
pt: no. we're just reviewing the same old stuff.
me: how come?
pt: for the PSSAs
me: when's that?
pt: in a few weeks
me: how does that make you feel?
pt's dad: he's nervous.
me: well, if you aren't learning anything new, then you must already know it all, right?
pt: i failed a couple sections.
me: which ones?
pt: inferencing and subtraction

(inferencing is not a word according to spell checker here.0

me: you'll get better if you keep practicing.

(primordial tiger mom speaking here....)

pt: oh, and we are supposed to have division, but we didn't learn that yet.
me: have you learned multiplication yet?
pt: OH YEAH!
me: if you can do multiplication, then division is just the opposite.
pt: OOOOOH. I KNOW WHAT 100 DIVIDED BY 100 IS.
me: you do?
pt: it's 1.
me: great. do you know why?
pt: no.
me: well, anything divided by itself is always 1. say you have 5...
pt: FIVE HUNDRED APPLES
me: right. and you have 500 people. how many apples does each person get?
pt: ONE!
me: ok. and say you have a pizza with 8 pieces, and there are 4 people in your family. how many pieces does each person get?
pt: some people eat three, and some people don't eat any.
pt's dad: nooooo, like, everyone gets the same amount of pizza.
pt: oh. two.
me: good! you know how to do division.
pt: and there are no leftovers.
me: correct. no remainders.
pt: my family always orders two pizzas.
me: ok.
pt: because everyone likes different kinds.
me: what's 'inferencing'? is that for science?
pt: no. it's for reading. like, you have to guess what happens next in a story.
me: oh. well, you should be pretty good at that since you were filling in all the blanks of the pizza story.
pt: duh! i already know my family!
me: -_-


good luck, son.

---
observations + analysis:
-this kid is probably at the top of the bell curve in my neighbourhood regarding conversation skills, according to my definition of conversation skills.
-semi-sad that kids have to learn 'to the test'
-wish that we could take these 'street smarts' and somehow translate as 'book smarts'
-or wish that education system could hone 'street smarts' into something that would help such kids become more socially mobile

When all your peers are gone

Saturday I was walking home from a friend's place and decided to cut through Phoenix park.
Lo and behold i ran into the church spring break interns cleaning up the park and painting the fence with the simple way folks. I stayed to chat for a bit, then promised to return later to hang out and enjoy the space.

Rewind- Phoenix park used to be an abandoned warehouse and twenty row homes. A seven-alarm fire started in the warehouse, destroyed the homes and displaced many people. This happened in 2007. Predictably the city didn't pay much mind to this marginalized community. Finally after five years the horticultural society gave some funds to plant grass. The simple way painted tires and starred lining the space with it. This past year a mural went up. I imagine it was named Phoenix park after the Phoenix..... Some strength and beauty coming outta the fire. Hopefully.

Anyway I returned after finishing my own chores. We played some soccer w neighbourhood kids. A nearby fight broke out. This was the first time I saw a street fight from beginning to end.  Beginning when two foolios are looking at each other in the face, then a crowd assembles, then everyone gets riled up, then some boys start taking off their shirts, or maybe just flashing some chest tattoos or pectoral muscles for intimidation? I have no idea. Finally someone throws the first punch. A guy ends up on the ground. The crowd is this flowing migrating amoeba. There is yelling. Once the guys is on the ground, everyone seems to want a chance at hitting/kicking, whether or not they were part of the original conflict. Then an older (40ish) man picks up the young buck off the sidewalk, tells him "get up" and walks him down the block. Chap's face is bloody.

Do I run over and make sure his teeth are ok??!!!! Just kidding.

He brawl is over because someone yells "popo is coming". A van with two female police officers drives up around the block.

So several thoughts:

-I am sick to my stomach whenever I see human brutality live. I can handle on tv and movies and video games. But when I see humanity engaging as animals, I need to barf.

-I am a shameless gawker.

-kudos to sue telling the kids to run away from violence, rather than towards it, as they started doing

-I bet the person who got beat was probably being obnoxious or offensive, even though I feel bad for him

-the older man who picked up the guy on the ground beat the inner city life expectancy for black males. Sadly the majority of killings in this part of town is against black and Hispanic makes 18-35. I wonder how many friends he has seen die. And I wonder how many of his peers are left. My grandparents as octogenarians always seemed a little forlorn to me. I would be too if I witnessed most of my peer group pass away.

------
An addendum here is that this week, pastor Fred gave a devotional for us at work. He mentioned a lot of conflict is because there is too much ME and not enough Jesus. Too many street fights coz "someone looked at me wrong" or too much drama at church coz "the pastor didn't pay attention to me".

Sigh. Is it not enough to know that the freaking God of the universe knows my name?! Let alone, He cares and died to save my soul from hell, and I didn't even have to do anything to earn it?! Do i always have to a cow when something doesn't go my way?!

Anyway, I guess being made aware of so much brokenness makes it much easier to desire eternity with God and for Jesus to come soon. Like now. I suppose that is partly why nuns and the pope practice this poverty thing.

Good night.

babel-ing 3

a happier, less moody post!

some praises to the Lord, which i am trying to articulate in a more polished writing format for our ehc newsletters (alas, my rusty writing brain!):

-one of the indonesian ladies who was rescued from some type of sexual slavery situation in freaking harrisburg, is coming tomorrow to receive her new dentures. finally! yay! they are my favourite patients who do not speak any of the languages i speak. hopefully they don't feel as awkward as i felt getting my hair chopped in chinatown yesterday, and not understanding anyyythingggg. (fu zhou hua, and gong dong hua)

-js, the 30 yr old who lost all her teeth from vehicle accident-related prescription narcotic drug abuse-related heroin abuse, also received her dentures recently. she scheduled her wedding two days later.

-my neighbour, who is a missionary in kensington, is receiving affordable care at our health center. she loves when the nurses pray with and for her. hooray!

babel-ing 2

when i see people doing stupid things each day........
  ok. i don't judge. it's just frustrating to read the news sometimes. or to see patients who are the people making the news.

sometimes i wonder if we've reached our intellectual peak as mankind.

the human genome is complete after all.






brain power is being replaced by smartphones.

folks don't know the difference between YOUR and YOU'RE anymore.

technology seems to be getting more expensive, rather than less expensive. major generalization here - just read an article on hospital billing.

so. i wonder if we have reached our knowledge tower of babel.

God is on the verge of humbling man, and taking back His glory. and now we all frustrate each other and look like idiots.

babel-ing

this past sunday's sermon was about how jesus drives the money changers and folks selling sacrifices at the temple out of the temple. the gist (always) is that jesus is passionate about God's glory. so when things aren't right in the heart, it doesn't matter how glorious it appears. the temple's purpose was to be a place of peace, forgiveness and teaching truth. instead, people were taking advantage of the situation, perhaps in the name of 'convenience' or 'one-stop shopping'. but, we can never really have 100% pure subservient motives. gaaaah. there is always that ugly residue of "meeeeeee meeee meeeeeeee!!!!!!! all about MOI!"
so, jesus sees through this and is upset.

i've been thinking about this as it relates to the church across the street. now that daylight is longer, i can see it more clearly on my walk home from work. i especially like to look at it at dusk. while at work, from our 7th story window, it's one of the only pretty buildings amidst the sea of row homes.

unfortunately, it's the inside that is decayed and destroyed. therefore it would cost millions to fix, which no one wants to invest. there isn't a thriving congregation attached to the building, hence the neglected upkeep, and the hearts of the people aren't there.

last week at our staff retreat, a westminster OT prof and another local pastor gave us teaching and exhortation about THE CHURCH. it was made clear that the Church is not a building, rather it is God's people. broken, messed up people. we can't be part of the church if we appear to be perfect.

except me. just kidding.

so. maybe it's okay that the church across the street will be torn down. i still fear the dust that i might be inhaling during the demolition. time to wear my filter mask i guess. but. i don't need to have a cow about it. the new prayer is not for something even prettier to be built there, but for space where grace and the gospel can be experienced. whatever that looks like.

different views on justice

today a very obnoxious 3 yr-old (patient's son) kicked me. he didn't kick me hard. no pain. and he more or less kicked my pant leg, then brushed my shin w/ his 12-inch leg and 5-inch foot. but it was definitely intentional. and then he smirked. i responded with a stern, "don't kick people. that's not nice!"

i proceeded to tell yoly and she responded with, "oooooooh. i woulda kicked him back and said, 'you don't like that, do you? so don't do it to others!"

and since i have to tell every remotely traumatic story at least five times in order to get it out of my system (therapy/catharsis, whatever you want to call it), i told terry. she did not hear yoly's response. nonetheless, she responded with, "oooooooh. i woulda kicked him back. like, 'oops. sorry!' don't tell anyone i said that."

so, i'm often alone in my views within this team. and, of course i attribute it to my east asian upbringing. it's probably not just that.

my analysis is that, for me, the shame of being reprimanded by an adult SHOULD have brought some guilt to this toddler, which would have led to behaviour change and rehabilitation. now that i think about it, that probably won't work for this kid.

for my teammates, it didn't matter that the boy was only three, or that he was a patient/patient's relative. eye for an eye, tooth for a tooth, b****!

WAPAH!

ok. just kidding. yeah. i dunno.
there are differences in discipline and perception of discipline.