August 2013 – Page 2 – Maria Yang, MD

It’s winter in New York City. The temperature is hovering around 32 degrees Fahrenheit. Large, slushy snowflakes are falling from the pewter sky.

You are already familiar with this woman; you had met her the previous Spring. No one is sure of her age, but she looks over 65 years old. She had said that she had immigrated to the US when she was in her 20s because she had a scholarship to a prestigious university. Something interrupted her schooling. She ultimately stopped attending classes and hitchhiked here. She’s been homeless on the streets of New York ever since.

She has never shared her date of birth for fear that the government would use that information against her. It’s not clear if her stated name is really her name. She’s a familiar figure in the neighborhood; people regularly give her styrofoam bowls steaming with hot soup, sandwiches wrapped in white butcher paper, shiny cans of soda, and cups of coffee. Some people have been giving her food for the past ten years. Upon receipt she murmurs, “Thank you,” and nods her head on her slender neck.

She never makes eye contact. The irises of her eyes have grey halos and her gaze is usually over your right shoulder. You’ve tried to learn more about her past, what led to her homelessness, and her interest in housing, but she usually ends the conversation and walks away. One time before bidding you good-bye she did comment, “The government secrets are safe with me.”

People in New York walk past her everyday while she sleeps and never realize it: She buries herself underneath black garbage bags stuffed with paper. What looks like a mountain of trash on the curb or underneath scaffolding is actually her private fort.

“The paper keeps me warm,” she has said. To prove her point while the autumn winds sent the dying leaves swirling through the air, she rolled up a sleeve of her parka to reveal wads of newspaper crumpled in her clothing. At times she donned a hat made out of a paper bag and stuffed it with newspaper to warm her head.

It is not yet 10am on this snowy morning and the weather forecasters predict that the storm will worsen as the day goes on. The snow is already sticking to the sidewalk. Over six inches are predicted to fall in the next few hours.

Today, the woman’s camp is underneath the short awning of the back door of a clothing boutique. Underneath her is a flattened cardboard box, the corners already beginning to darken and soften from the snow. On top of her are only four or five garbage bags, fewer than what usually covers her. Upon hearing you, she sits up and her face, as expected, does not show any expression.

Her parka is unbuttoned and underneath is a thin white shirt with a tattered collar. The skin of her neck is mottled and red.

“There’s a snowstorm coming through, it’s supposed to be pretty bad. Would you be willing to stay in a shelter until it’s done?” you ask.

“No, I’ll be fine.”

“It looks like you’re cold; you don’t have as many bags as you usually do and your skin is turning red. We don’t want you to be outside when it is this cold out,” you try again.

“I’m fine.”

“We worry that if you stay out here, you might get frostbite.”

“I’m fine.”

“Where have you gone in the past when there were big snowstorms?”

“I’m fine.”

Meanwhile, snow is beginning to collect on her coat, her bags, and in her hair. She makes no motion to move.

Does this woman have a mental illness? Does she need to be sent to the hospital for psychiatric evaluation? If she doesn’t want to go to the hospital, should she be forced to go to the hospital against her will?

I remember when we dragged ourselves to the large lecture hall every morning, backpacks slung over our shoulders and cups of coffee in our hands. Six to eight hours of lectures awaited us.

I remember where we all sat in that lecture hall. I remember the future ophthalmologist who sat behind me and made snarky comments while certain professors gave their lectures facing the chalkboard. I remember students sitting six rows behind me who told me after class, “We saw you falling asleep today. If you sit in the back, it won’t be as obvious.”

I remember the guys throwing around a fluorescent Nerf football between classes. Some of them would take off their shirts (and one would look around to see if women were watching) and relive their days of playing college sports.

I remember when we wore shorts, tee shirts, sandals, tattered jeans, dangling earrings, and tank tops.

I remember going to parties and watching people drink wine and beer out of those red plastic cups.

I remember when we received the short white coats. I remember how stiff they were, how awkward we looked in them, and how annoyed we were that we had to buy “nice clothes” in preparation of training in the hospitals.

I remember that we exchanged ideas of where to find “nice clothes” for “cheap”.

I remember how tired and haggard we looked after we took call. I remember when our scrubs were wrinkled, our hair was unkempt, and our hygiene was suboptimal.

I remember when we wondered how we would ever survive our intern year.

I remember when we contaminated sterile fields and didn’t know what size sterile gloves we needed. I remember certain nurses rolling their eyes and yelling at us for our ignorance. I remember when we would see each other in the hallways and stairwells, holding order sheets for signatures, carrying baskets filled with gauze and tape, and trailing behind the medical team that was into its third hour of rounding.

I remember when we tried not to cry when attending and resident physicians said unkind things. I remember when we shared strategies about how to manage certain doctors. I remember how much we said, “I don’t know.”

I now see current photos of my classmates from medical school and, to my surprise, they actually look like doctors. They have wrinkles around their eyes. The men wear white collared shirts, mild neckties, and dark business jackets. The women wear conservative jewelry and shirts with modest necklines. The long white coats fit their frames. Their smiles radiate confidence.

They look mature.

And old.

Which means I must look that way, too.